DOP040 Anti-TNF-α therapies are safe during pregnancy in patients with inflammatory bowel disease: a meta-analysis

Narula, N; Al-Dabbagh, Raed; Dhillon, Amit; Marshall, John K.

doi:10.1016/s1873-9946(14)60065-9

Cited by 2 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is well established that anti-TNFα agents themselves do not increase the risk of adverse pregnancy outcomes. 16,[58][59][60] Narula et al 61 published the first meta-analysis reporting on the safety of infliximab, adalimumab and certolizumab treatment during pregnancy. Later, Shihab et al 62 issued a second meta-analyses that, again, found no increased risk of adverse pregnancy outcomes for patients on these anti-TNFα agents compared with matched controls.…”

Section: ) Clinical Impactmentioning

confidence: 99%

“…73 Finally, two meta-analysis found that there is no data that demonstrates a risk of increased infection or neonate immune system disorder due to anti-TNFα exposure. 61,62 Current guidelines recommend avoiding live vaccines, such as BCG and rotavirus, during the first 6 -9 months for infants exposed to anti-TNFα treatment in utero. Other vaccination strategies follow the recommendations from national guidelines, as the infants can adequately respond to non-live vaccines.…”

Section: ) Clinical Impactmentioning

confidence: 99%

See 1 more Smart Citation

A Narrative Review on Anti-Tumor Necrosis Factor α Therapies in Inflammatory Bowel Disease During Pregnancy: Immunoglobulin Placental Translocation and its Impact

Roseira¹,

Ramos²

2019

Acta Med Port

View full text Add to dashboard Cite

Introduction: Inflammatory bowel disease activity is associated with adverse pregnancy outcomes. Anti-tumor necrosis factor α therapy is often required to treat flares and to maintain disease remission. However, there are concerns regarding treatment with these agents during pregnancy, as they actively cross the placental barrier.Material and Methods: Studies regarding anti-tumor necrosis factor α therapy during pregnancy were identified from PubMed from 1958 to January 2018. The reference lists of the selected studies were reviewed to identify complementary publications.Results and Discussion: Anti-tumor necrosis factor α agents are efficient treatments for moderate-to-severe inflammatory bowel disease and may ensure remission during pregnancy. Although these drugs cross the placenta, they are considered safe for both the mother and the fetus. Furthermore, up-to-date guidelines support therapy continuation during pregnancy aiming for disease control. The same guidelines also consider stopping treatment during the third trimester to limit maternal-fetal drug transfer. However, data shows that this strategy does not completely prevent fetus exposure. In addition, stopping treatment incurs in risk of disease flare and threatens subsequent therapy response. Fetus drug exposure has not showed an association with adverse childhood development. However, as infant drug levels could be detected up to seven months after birth, postponement of live virus vaccination is recommended.Conclusion: There should be no disagreement among the medical community as to the need to maintain therapy aiming for disease remission during gestation in inflammatory bowel disease. Anti-tumor necrosis factor α agents are safe for both the mother and the fetus.

show abstract

Section: ) Clinical Impactmentioning

confidence: 99%

Section: ) Clinical Impactmentioning

confidence: 99%

A Narrative Review on Anti-Tumor Necrosis Factor α Therapies in Inflammatory Bowel Disease During Pregnancy: Immunoglobulin Placental Translocation and its Impact

Roseira¹,

Ramos²

2019

Acta Med Port

View full text Add to dashboard Cite

show abstract

Safety of Immunomodulators and Anti-TNF Therapy in Pregnancy

Chaudrey

Kane

2015

Curr Treat Options Gastro

View full text Add to dashboard Cite

Biologics have proved to be extremely effective therapies for active, difficult to treat ulcerative colitis and Crohn's disease. Given that active disease appears to be what drives worse outcomes in conception and pregnancy, understanding of the potential risks of continued biologic therapy during pregnancy is important. Knowledge of the mechanisms of placental transfer helps clinicians explain to patients the timing of potential cessation of therapy, and the ongoing data collection from the efforts of the Crohn's and Colitis Pregnancy Registry have helped immensely to move this field forward. The body of evidence for use of thiopurines as well has supported their continued use during pregnancy in patients, despite their category D rating. Family planning and counseling have come a long way with our efforts in understanding that the real enemy is active inflammation, not the therapies we use to treat it.

show abstract

DOP040 Anti-TNF-α therapies are safe during pregnancy in patients with inflammatory bowel disease: a meta-analysis

Cited by 2 publications

References 0 publications

A Narrative Review on Anti-Tumor Necrosis Factor α Therapies in Inflammatory Bowel Disease During Pregnancy: Immunoglobulin Placental Translocation and its Impact

A Narrative Review on Anti-Tumor Necrosis Factor α Therapies in Inflammatory Bowel Disease During Pregnancy: Immunoglobulin Placental Translocation and its Impact

Safety of Immunomodulators and Anti-TNF Therapy in Pregnancy

Contact Info

Product

Resources

About