Pregnancy outcome in patients with inflammatory bowel disease treated with thiopurines: cohort from the CESAME Study

Coelho, Jessica; Beaugerie, Laurent; Colombel, J.F.; Hébuterne, Xavier; Lerebours, Éric; Lémann, Marc; Bäumer, P.; Cosnes, Jacques; Bourreille, Arnaud; Jp, Gendre; Seksik, Philippe; Blain, Antoine; Metman, Étienne-Henry; Nisard, A; Cadiot, Guillaume; Veyrac, M.; Coffin, Benoït; Dray, Xavier; Carrat, Fabrice; Marteau, Philippe

doi:10.1136/gut.2010.222893

Cited by 163 publications

(101 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Consequently some, caution is warranted with the use of these drugs. Despite limitations of these studies e.g., relatively small sample sizes, or failure to consider the disease activity of IBD, these data are consistent with very moderate thiopurine use as potentially safe during pregnancy [56,57,117] .…”

Section: -Mp/azasupporting

confidence: 55%

“…The PIANO registry as of 2012 studied 291 patients exposed to biologic therapy alone and 75 patients exposed to biologics and immunomodulators [117] , and found no increase in congenital abnormalities, infections, or developmental delays which could be clearly attributed to these drugs. Interestingly in the combination group, when CZP was left out of the analysis and only INF and ADA were analyzed individually, there was an increase in infections in the combination therapy group [117] .…”

Section: Biologicsmentioning

confidence: 99%

“…Interestingly in the combination group, when CZP was left out of the analysis and only INF and ADA were analyzed individually, there was an increase in infections in the combination therapy group [117] . This suggested that the presence of placentally transferred IgG1 antibodies in INF and ADA treatment groups might have contributed to an increased infection risk.…”

Section: Biologicsmentioning

confidence: 99%

“…Coelho et al [117] ran a sub study that was added to the CESAME in 2005, which included 86 thiopurine-treated pregnancies compared to 129 IBD controlled pregnant patients. One of the main findings of the study was that there were no increases in congenital abnormalities in thiopurine-treated pregnancies [117] . Therefore we believe that benefits from maintenance on these immunomodulators during pregnancy may in some cases outweigh potential fetal risks.…”

Section: -Mp/azamentioning

confidence: 99%

See 3 more Smart Citations

Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management

Hosseini‐Carroll¹,

Mutyala²,

Seth³

et al. 2015

WJGPT

View full text Add to dashboard Cite

Manas K made critical revisions of the manuscript; Becker F and Alexander JS contributed equally as senior authors. Conflict-of-interest statement:There are no known conflicts of interest. The authors (Pegah Hosseini-Carroll, Monica Mutyala, Abhishek Seth, Shaheen Nageeb, Demiana Soliman, Moheb Boktor, Ankur Sheth, Jonathon Chapman, James Morris, Paul Jordan, Kenneth Manas, Felix Becker, and J Steven Alexander) have no relevant financial considerations related to this proposal, and the study was not supported by any corporate entity. There is no known intellectual property associated with this report. AbstractInflammatory bowel diseases (IBD) are chronic idiopathic inflammatory conditions characterized by relapsing and remitting episodes of inflammation which can affect several different regions of the gastrointestinal tract, but also shows extra-intestinal manifestations. IBD is most frequently diagnosed during peak female reproductive years, with 25% of women with IBD conceiving after their diagnosis. While IBD therapy has improved dramatically with enhanced surveillance and more abundant and powerful treatment options, IBD disease can have important effects on pregnancy and presents several challenges for maintaining optimal outcomes for mothers with IBD and the developing fetus/neonate. Women with IBD, the medical team treating them (both gastroenterologists and obstetricians/gynecologists) must often make highly complicated choices regarding conception, pregnancy, and post-natal care (particularly breastfeeding) related to their choice of treatment options at different phases of pregnancy as well as post-partum. This current review discusses current concerns and recommendations for pregnancy during 157November 6, 2015|Volume 6|Issue 4| WJGPT|www.wjgnet.com Hosseini-Carroll P et al . Pregnancy and inflammatory bowel diseases IBD and is intended for gastroenterologists, general practitioners and IBD patients intending to become, (or already) pregnant, and their families. We have addressed patterns of IBD inheritance, effects of IBD on fertility and conception (in both men and women), the effects of IBD disease activity on maintenance of pregnancy and outcomes, risks of diagnostic procedures during pregnancy and potential risks and complications associated with different classes of IBD therapeutics. We also have evaluated the clinical experience using "top-down" care with biologics, which is currently the standard care at our institution. Post-partum care and breastfeeding recommendations are also addressed. Core tip: Inflammatory bowel diseases (IBD) are chronic inflammatory conditions characterized by relapsing and remitting episodes of intestinal inflammation. IBD is most frequently diagnosed during peak female reproductive years, with 25% of women with IBD conceiving after their diagnosis. While therapies have improved dramatically, IBDs have important effects on pregnancy and present challenges for maintaining optimal outcomes for mothers and their developing fetus/ neonate. Women with IBD and physician...

show abstract

Section: -Mp/azasupporting

confidence: 55%

Section: Biologicsmentioning

confidence: 99%

Section: Biologicsmentioning

confidence: 99%

Section: -Mp/azamentioning

confidence: 99%

See 2 more Smart Citations

Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management

Hosseini‐Carroll¹,

Mutyala²,

Seth³

et al. 2015

WJGPT

View full text Add to dashboard Cite

show abstract

“…This group found no statistically significant difference in the rate of major malformations (3.5 vs 3%; OR: 1.17; 95% CI: 0.37-3.69), but exposed infants did have a statistically significant increase in premature birth and low birthweight. A more recent French study of 204 pregnant women with IBD found no association between AZA use and risk of adverse pregnancy outcomes, such as interrupted pregnancies (due to spontaneous or elective abortion), congenital abnormalities, preterm deliveries or low birthweight [86].…”

Section: Reviewmentioning

confidence: 99%

Management of inflammatory bowel disease in pregnancy

Ng¹,

2013

Expert Review of Clinical Immunology

View full text Add to dashboard Cite

Approach to Gastrointestinal and Liver Diseases in Pregnancy

Saha

Reau

2015

Yamada' S Textbook of Gastroenterology

View full text Add to dashboard Cite

Pregnancy outcome in patients with inflammatory bowel disease treated with thiopurines: cohort from the CESAME Study

Abstract: The results obtained from this cohort indicate that thiopurine use during pregnancy is not associated with increased risks, including congenital abnormalities.

Cited by 163 publications

References 24 publications

Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management

Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management

Management of inflammatory bowel disease in pregnancy

Approach to Gastrointestinal and Liver Diseases in Pregnancy

Contact Info

Product

Resources

About