Disease Management Clinical Decisions:
Produced by The Cleveland Clinic Foundation Center for Continuing Education.

Rheumatoid Arthritis in Pregnancy

Release Date:   November 8, 2013

Estimated Time of Completion:  15 minutes


This is an interactive case-based lesson from the Cleveland Clinic Foundation Center for Continuing Education. Read each section of the case and answer the questions. You may proceed to the next section once you answer each question correctly. In addition to allowing you to proceed, the correct answer also reveals the rationale, with references when appropriate. Upon completing the CME activity and the evaluation and registration forms, you will have an opportunity to print your CME certificate for your records.

Learning Objectives

At the conclusion of this activity, the participant will be able to:

  1. Describe the effect of physiological changes that occur during pregnancy on rheumatoid arthritis.

  2. Describe the course of rheumatoid arthritis during pregnancy.

  3. Describe the challenges and importance of treating rheumatoid arthritis in pregnancy.

  4. Appraise the data on the safety and use of anti-rheumatic therapies during pregnancy.

Target Audience

Directed to primary care physicians including family practitioners and internists.

Activity Director and Faculty

Co-Activity Director

Kenneth Goodman, MD
Associate Director,
Center for Continuing Medical Education
Cleveland Clinic
Cleveland, OH

Alexander Duart Rae-Grant, MD
Mellen Center,
Cleveland Clinic
Cleveland, OH


Cassandra M. Calabrese, DO
Department of Internal Medicine
Cleveland Clinic, Cleveland, OH

Leonard H. Calabrese, DO
Professor of Medicine,
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University,
R.J. Fasenmyer Chair of Clinical Immunology,
Vice Chairman, Department of Rheumatic and Immunologic Diseases Orthopaedic and Rheumatologic Institute ,
Cleveland Clinic, Cleveland, OH


The information in this educational activity is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician or other health care provider relative to diagnostic and treatment options of a specific patient's medical condition. The viewpoints expressed in this educational activity are those of the authors/faculty. They do not represent an endorsement by The Cleveland Clinic Foundation. In no event will The Cleveland Clinic Foundation or Peking Union Medical College Hospital be liable for any decision made or action taken in reliance upon the information provided through this educational activity.


In accordance with the Standards for Commercial Support issued by the Accreditation Council for Continuing Medical Education (ACCME), The Cleveland Clinic Foundation Center for Continuing Education requires resolution of all faculty conflicts of interest to ensure CME activities are free of commercial bias.

The following faculty has indicated that he may have a relationship which, in the context of his presentation, could be perceived as a potential conflict of interest:

Leonard H. Calabrese, DO
Consulting; Teaching and Speaking Amgens
Consulting BMS
Consulting; Teaching and Speaking Centocor
Consulting; Teaching and Speaking Genentech/Roche
Consulting; Teaching and Speaking Pfizer
Consulting; Data Safety Monitoring Board Sanofi Aventis
Consulting; Data Safety Monitoring Board Savient

The following faculty has indicated that she has no relationship which, in the context of her presentation, could be perceived as potential conflict of interest:

Kenneth Goodman, MD
Alexander Duart Rae-Grant, MD
Cassandra M. Calabrese, DO

All other planners, CME staff, and content reviewers have no relevant financial relationships to disclose.

Begin Activity in English

How to Obtain Your Certificate of Participation

  1. Participate in the activity.
  2. Login to your account.
  3. Complete the evaluation.
  4. Print your certificate.