I would ask you reconsider your comment of no problems with leflunomide and pregnancy. you are correct. LEF is officially a teratogen (mainly on animal data) and is contraindicated in pregnancy/conception and use to be labeled as a category "X" risk before they changed to to the new PLLR safety warnings for pregnancy. But your point is that there are several cohort reports of >100 pregnant patients (usually RA) who took LEF at conception or early in pregnancy with near normal outcomes and no/few malformations. My study of LEF and pregnancy leaves me to believe that I avoid LEF in women who wish to become pregnancy; but if by chance a patient on LEF becomes pregnant, the actual risk of fetal malformation are very low and way lower than mycophenolate. Mycophenolate is the most teratogenic drug we rheumatologists use in practice (admitting we hardly every use CTX anymore)
I would ask you reconsider your comment of no problems with leflunomide and pregnancy. you are correct. LEF is officially a teratogen (mainly on animal data) and is contraindicated in pregnancy/conception and use to be labeled as a category "X" risk before they changed to to the new PLLR safety warnings for pregnancy. But your point is that there are several cohort reports of >100 pregnant patients (usually RA) who took LEF at conception or early in pregnancy with near normal outcomes and no/few malformations. My study of LEF and pregnancy leaves me to believe that I avoid LEF in women who wish to become pregnancy; but if by chance a patient on LEF becomes pregnant, the actual risk of fetal malformation are very low and way lower than mycophenolate. Mycophenolate is the most teratogenic drug we rheumatologists use in practice (admitting we hardly every use CTX anymore)