Smeele HTW, Röder E, Wintjes HM, et al. - Impairment in fertility outcomes and increased risk of adverse pregnancy outcomes are observed among patients with rheumatoid arthritis (RA) who exhibit high disease activity. Researchers here examined whether a modern treatment approach, including treat-to-target (T2T) and the prescription of tumour necrosis factor (TNF) inhibitors, is feasible in patients with RA with a wish to conceive or who are pregnant. From the Preconception Counseling in Active RA (PreCARA) cohort, they identified 309 patients with RA for inclusion in this study. Birth of 188 children was reported. Use of a TNF inhibitor was reported in 47.3% of the patients at any time during pregnancy. This study is identified to be the first work on a modern treatment approach in pregnant patients with RA. Findings suggest that low disease activity and remission are an achievable goal during pregnancy, with 90.4% of patients attaining this in the third trimester.