Treatment with biologics of pregnant patients with rheumatic diseases

Abstract

Differences in molecular structure of TNFα inhibitors may turn out to favor the use of agents that are not complete monoclonal antibodies in women who consider pregnancy. The very limited experience with abatacept, tocilizumab or anakinra in pregnancy allows no statement as to their compatibility with pregnancy. At present use of biological agents throughout pregnancy cannot be recommended.

Flares of systemic lupus erythematosus during pregnancy and the puerperium: prevention, diagnosis and management

“…To date, studies of children who were exposed to rituximab early in pregnancy have not demonstrated any adverse outcomes. By contrast, second-and third-trimester exposure causes B-cell depletion in the fetus with unknown long-term effects [100]. Although few congenital malformations or neonatal infections were seen among exposed neonates, women should continue to be counseled to avoid pregnancy for 6-12 months after rituximab exposure [101,102].…”

Kronisk inflammatorisk artritt og svangerskap

“…Tabell 1 viser de mest brukte medikamentene for artrittsykdom og råd om bruk under svangerskap (44,46,47).…”

“…Dyrestudier og data fra human eksponering i svangerskap tyder ikke på økt risiko for misdannelser hos fosteret (46,47), men erfaringen er fortsatt begrenset.…”

“…Monoklonale antistoffer passerer placenta, og konsentrasjonen i navlestrengsblod øker i siste trimester og når samme nivå som hos moren ved fødselen (47). Adalimumab, etanercept og infliximab kan i henhold til nyere ekspertråd brukes frem til konstatert graviditet (47).…”

“…Adalimumab, etanercept og infliximab kan i henhold til nyere ekspertråd brukes frem til konstatert graviditet (47).…”