Lupus & antiphospholipid syndrome
Increased Risk of Intrahepatic Cholestasis of Pregnancy in Women With Systemic Lupus Erythematosus Exposed to Azathioprine
Authors' conclusion
We observed that AZA exposure may be strongly associated with ICP in SLE pregnancies.
Study context
- Population
- Pregnant women with systemic lupus erythematosus (SLE) enrolled before 17 weeks with a second-trimester visit, LEGACY cohort (Canada, South Korea, Peru, Mexico)
- Participants
- 127 SLE pregnancies
- Exposure
- AZA-exposed vs unexposed SLE pregnancies
- AZA exposedn = 46
- Unexposedn = 81reference
- Outcome
- Iatrogenic delivery for ICP or spontaneous preterm birth occurring after ICP diagnosis
Methodological detailsmulticentre, time-varying exposure, multivariable Cox models with frailties
- Multicentre
- Time-varying exposure
- Multivariable Cox models with frailties
Main finding
As reported in the abstract
Intrahepatic cholestasis of pregnancy (ICP)
Observational data: associations, not effects.
Further findings
Second-trimester thiopurine shunting (Montreal site, metabolite data)
- Intrahepatic cholestasis of pregnancy (ICP) cases with metabolite data showing shunting
- 4 of 4
- Pregnancies with metabolite data (n = 22) shunting
- 36.4% (95% CI 19.7-57.0)
- Shunting pregnancies developing ICP
- 50.0% (95% CI 21.5-78.5)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Increased Risk of Intrahepatic Cholestasis of Pregnancy in Women With Systemic Lupus Erythematosus Exposed to Azathioprine. Arthritis Rheumatol. Published 4 May 2026. doi:10.
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