Anti-Tumour Necrosis Factor α Therapies and Inflammatory Bowel Disease Pregnancy Outcomes: A Meta-analysis

Shihab, Zaid; Yeomans, Neville D; Cruz, Peter De

doi:10.1093/ecco-jcc/jjv234

Cited by 65 publications

(56 citation statements)

References 78 publications

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“…Tumour necrosis factor (TNF) antagonists have the most data available, with several reports of safe use, although etanercept has been associated with an increased risk of spontaneous abortion in the first trimester . A recent meta‐analysis of 482 patients with IBD exposed to TNF antagonists during pregnancy did not find any association with adverse pregnancy outcomes (pooled OR 1·14, 95% CI 0·73–1·78; P = 0·55) …”

Section: Discussionmentioning

confidence: 99%

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Psoriasis and adverse pregnancy outcomes: a systematic review of observational studies

et al. 2016

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Psoriasis is a chronic inflammatory disorder with significant physical and psychological sequelae. The majority of individuals experience disease onset in early adult life - for women this often occurs during their reproductive years. While some autoimmune diseases have been shown to affect pregnancy outcomes adversely, such a relationship has not been well studied in psoriasis. We searched PubMed, Embase and the Cochrane database for published articles examining psoriasis and adverse pregnancy outcomes, and included observational studies and clinical trials evaluating direct measures of maternal and fetal morbidity and mortality. Four of the nine included articles reported a statistically significant increase in the risk of at least one outcome, including spontaneous abortion, caesarean delivery, low birth weight, macrosomia, large-for-gestational age, and a composite outcome consisting of both prematurity and low birth weight. However, these associations were not always consistent across studies. Overall, there was no clear evidence of increased adverse outcomes in pregnant women with psoriasis.

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Section: Discussionmentioning

confidence: 99%

“…26 A recent meta-analysis of 482 patients with IBD exposed to TNF antagonists during pregnancy did not find any association with adverse pregnancy outcomes (pooled OR 1Á14, 95% CI 0Á73-1Á78; P = 0Á55). 28…”

Section: Discussionmentioning

confidence: 99%

Psoriasis and adverse pregnancy outcomes: a systematic review of observational studies

et al. 2016

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“…Shihab, Yeomans, and De Cruz () performed a systematic review and meta‐analysis of the available literature on the exposure of anti‐TNF therapy in pregnant women with inflammatory bowel disease. They did not find an increase of adverse pregnancy outcomes, congenital abnormalities, premature birth or low birth weight compared with disease‐matched controls.…”

Section: Discussionmentioning

confidence: 99%

“…These diseases share common genetics involved and the balance between the cytokines Th17 and Tregs, which allows a certain comparison (Skroza, Proietti, & Pampena, 2013). Shihab, Yeomans, and De Cruz (2016) performed a systematic review and meta-analysis of the available literature on the exposure of anti-TNF therapy in pregnant women with inflammatory bowel disease.…”

Section: Year Of Deliverymentioning

confidence: 99%

Use of TNF-inhibitors and ustekinumab for psoriasis during pregnancy: A patient series

Lund

Thomsen

2017

Dermatologic Therapy

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From 2002 to 2016 a total of seven women with severe refractory psoriasis were exposed to the TNF-inhibitors infliximab and adalimumab or to the IL12/23 inhibitor ustekinumab during one or more pregnancies. Maternal, fetal or teratogenic toxicity were not detected during pregnancy and puerperium. All pregnancies were uneventful and resulted in delivery of 10 healthy children in total, one of the women is due February 2017. Postpartum, five of the women were lactating, but none of the women or newborns developed adverse reactions. Data on safety of treatment during breastfeeding are sparse, but so far appears to be safe due to the lack of absorption across the gastrointestinal lining. Currently biological therapy with either TNF-inhibitors or ustekinumab is not recommended during pregnancy, however in selected women with severe psoriasis these treatment modalities may be considered.

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“…Many studies and publications on pregnancies under IFX treatment have shown no indications of elevated malformation risks [25, 51–53]. …”

Section: Biologics: Tnf-α Inhibitorsmentioning

confidence: 99%

Immunosuppressives and biologics during pregnancy and lactation

Puchner

Gröchenig

Sautner

et al. 2019

Wien Klin Wochenschr

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SummaryAn increasing and early-onset use of immunosuppressives and biologics has become more frequently seen among patients with inflammatory bowel diseases (IBD) and rheumatic disorders. Many women in their childbearing years currently receive such medications, and some of them in an interdisciplinary setting. Many questions arise in women already pregnant or wishing to conceive with respect to continuing or discontinuing treatment, the risks borne by the newborns and their mothers and long-term safety. Together with the Austrian Society of Rheumatology and Rehabilitation, the IBD working group of the Austrian Society of Gastroenterology and Hepatology has elaborated consensus statements on the use of immunosuppressives and biologics in pregnancy and lactation. This is the first Austrian interdisciplinary consensus on this topic. It is intended to serve as a basis and support for providing advice to our patients and their treating physicians.

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Anti-Tumour Necrosis Factor α Therapies and Inflammatory Bowel Disease Pregnancy Outcomes: A Meta-analysis

Cited by 65 publications

References 78 publications

Psoriasis and adverse pregnancy outcomes: a systematic review of observational studies

Psoriasis and adverse pregnancy outcomes: a systematic review of observational studies

Use of TNF-inhibitors and ustekinumab for psoriasis during pregnancy: A patient series

Immunosuppressives and biologics during pregnancy and lactation

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