P817 Live-vaccines and lactation in newborn exposed in utero to anti-TNF: A multi-centre French experience in inflammatory bowel disease

Bendaoud, S; Nahon, Stéphane; Gornet, Jean–Marc; Pariente, Benjamin; Beaugerie, Laurent; Abitbol, Véred; Peyrin–Biroulet, Laurent; Buisson, Anthony; Hébuterne, Xavier; Altwegg, Romain; Amil, Morgane; Rosa, Isabelle; Héluwaert, Frédéric; Antony, Molly; Boureille, Arnaud; Bouhnik, Yoram; Quentin, V.; Aubourg, Alexandre; Boualit, Médina; Bideau, Karine; Cuillerier, Emmanuel; Locher, Christopher P.

doi:10.1093/ecco-jcc/jjx180.944

Cited by 11 publications

(10 citation statements)

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“…Offspring exposed to anti-TNF drugs, vedolizumab and ustekinumab in utero are able to mount appropriate antibody responses to inactivated vaccines and should complete the inactivated vaccine programme as scheduled 1201. A multicentre observational retrospective study from 22 French gastroenterology departments was recently presented in abstract form 1202. The study aimed to determine the rate and tolerance of live vaccines in children before and following 6 months of life when exposed in utero to anti-TNF therapy and in children breastfed by mothers receiving anti-TNF.…”

Section: Common Disease Considerationsmentioning

confidence: 99%

British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults

Lamb

Kennedy

Raine

et al. 2019

Gut

1,721

1,816

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Ulcerative colitis and Crohn’s disease are the principal forms of inflammatory bowel disease. Both represent chronic inflammation of the gastrointestinal tract, which displays heterogeneity in inflammatory and symptomatic burden between patients and within individuals over time. Optimal management relies on understanding and tailoring evidence-based interventions by clinicians in partnership with patients. This guideline for management of inflammatory bowel disease in adults over 16 years of age was developed by Stakeholders representing UK physicians (British Society of Gastroenterology), surgeons (Association of Coloproctology of Great Britain and Ireland), specialist nurses (Royal College of Nursing), paediatricians (British Society of Paediatric Gastroenterology, Hepatology and Nutrition), dietitians (British Dietetic Association), radiologists (British Society of Gastrointestinal and Abdominal Radiology), general practitioners (Primary Care Society for Gastroenterology) and patients (Crohn’s and Colitis UK). A systematic review of 88 247 publications and a Delphi consensus process involving 81 multidisciplinary clinicians and patients was undertaken to develop 168 evidence- and expert opinion-based recommendations for pharmacological, non-pharmacological and surgical interventions, as well as optimal service delivery in the management of both ulcerative colitis and Crohn’s disease. Comprehensive up-to-date guidance is provided regarding indications for, initiation and monitoring of immunosuppressive therapies, nutrition interventions, pre-, peri- and postoperative management, as well as structure and function of the multidisciplinary team and integration between primary and secondary care. Twenty research priorities to inform future clinical management are presented, alongside objective measurement of priority importance, determined by 2379 electronic survey responses from individuals living with ulcerative colitis and Crohn’s disease, including patients, their families and friends.

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Section: Common Disease Considerationsmentioning

confidence: 99%

British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults

Lamb

Kennedy

Raine

et al. 2019

Gut

1,721

1,816

View full text Add to dashboard Cite

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“…Regarding vaccination (one or more vaccinations with Bacillus Calmette-Guérin (BCG), rotavirus, Haemophilus influenzae type b (Hib), tetanus, or hepatitis B), in total 197 cases were investigated in different publications [1,43,51,58,62,77,94,100,109,137]. Twenty-nine cases were investigated regarding response to tetanus and hepatitis B vaccination, of which 28 had adequate response [28,51,62,77,100].…”

Section: Infliximabmentioning

confidence: 99%

Intrauterine Exposure to Biologics in Inflammatory Autoimmune Diseases: A Systematic Review

Ghalandari

Dolhain

Hazes

et al. 2020

Drugs

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Background Inflammatory autoimmune diseases are chronic diseases that often affect women of childbearing age. Therefore, detailed knowledge of the safety profile of medications used for management of inflammatory autoimmune diseases during pregnancy is important. However, in many cases the potential harmful effects of medications (especially biologics) during pregnancy (and lactation) on mother and child have not been fully identified. Objective Our aim was to update the data on the occurrence of miscarriages and (major) congenital malformations when using biologics during pregnancy based on newly published articles. Additionally, we selected several different secondary outcomes that may be of interest for clinicians, especially information on adverse events in the use of a specific biologic during pregnancy. Material and Methods A search was conducted from 1 January 2015 until 4 July 2019 in Embase.com, Medline Ovid, Web of Science, Cochrane CENTRAL, and Google Scholar with specific search terms for each database. Selection of publications was based on title/abstract and followed by full text (double blinded, two researchers). An overview was made based on outcomes of interest. References of the included publications were reviewed to include and minimize the missing publications. Results A total of 143 publications were included. The total number of cases ranged from nine for canakinumab to 4276 for infliximab. The rates of miscarriages and major congenital malformations did not show relevant differences from those rates in the general population. Conclusion Despite limitations to our study, no major safety issues were reported and no trend could be identified in the reported malformations.

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“…102 A newer French study questions the risk of giving live vaccinations within 6 months, as they found that only 1 in 19 infants had an adverse reaction (abscess with favorable evolution), and 7 children received rotavirus vaccination with only one fever reported. 103 Of the 40 infants of exposed mothers who received the rotavirus vaccine in the Beaulieu study above, there were no serious adverse reactions and mild events occurred at a similar rate to the general population. 101 Despite these findings, we support current guideline recommendations of waiting until 6-12 months of age to give live vaccinations.…”

Section: Cyclosporinementioning

confidence: 85%

Insights into the treatment of inflammatory bowel disease in pregnancy

Shannahan

Erlich

Peppercorn

2019

Therap Adv Gastroenterol

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Patients diagnosed with inflammatory bowel disease (IBD) are most commonly diagnosed in late adolescence or early adulthood, with half of patients being diagnosed before age 32, thus impacting peak years of reproduction and family planning. While controlled IBD has no negative effects on the ability to conceive, there is overall a trend towards voluntary childlessness due to patients’ concerns for adverse fetal outcomes from underlying IBD and from adverse medication effects. Active disease at the time of conception is associated with worsening disease activity during pregnancy and carries a higher risk of poor fetal outcomes. It is therefore important to maintain remission during pregnancy, which is often achieved with pharmacologic therapy. The goal of this paper is to provide a comprehensive review of the current literature and safety data for pharmacologic treatment of IBD in pregnancy, in breastfeeding women, and in men planning to have children.

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P817 Live-vaccines and lactation in newborn exposed in utero to anti-TNF: A multi-centre French experience in inflammatory bowel disease

Cited by 11 publications

References 0 publications

British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults

British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults

Intrauterine Exposure to Biologics in Inflammatory Autoimmune Diseases: A Systematic Review

Insights into the treatment of inflammatory bowel disease in pregnancy

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