Do you switch to certolizumab in RA patients who are doing well on other TNFis and planning to become pregnant?

I have not “switched” any patients who are stable and doing well on an anti-TNF agent when the issue of pregnancy arises. The risk of flare remains a concern in this situation. There is enough data-base derived information (such as the OTIS registry) to suggest safety to continue an established anti-TNF agent regimen/therapy into a pregnancy. I have, on occasion, made an argument for a woman of child bearing potential (WOCBP) to “start” with certolizumab for therapy when the patient is open to p...