Document Detail


Anti-TNF antibody therapy for inflammatory bowel disease during pregnancy: a clinical review.
MedLine Citation:
PMID:  19916950     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The incidence of inflammatory bowel disease (IBD; Crohn's disease, ulcerative colitis) is highest during the peak reproductive years, hence the increased concern with the safety of IBD drugs during pregnancy. Over the past 11 years, anti-TNF-alpha antibody therapy has emerged as a treatment approach for refractory IBD patients who have failed to achieve or maintain remission with corticosteroids and immunomodulator agents. The TNF-alpha inhibitors (anti-TNFs; infliximab, adalimumab, certolizumab pegol) have proven successful in inducing and maintaining remission of moderate-to-severe IBD, but recommendations for the use of these compounds during pregnancy have lacked consensus. Balanced against the potential risk of these drugs on the fetus is the well-established fact that high disease activity has been found to poorly affect pregnancy outcomes in IBD, and the potential use of anti-TNF agents may control disease flare and severity during pregnancy. Concerns regarding the effect of anti-TNFs on the pregnancy and fetus have been assuaged by registry data which has demonstrated an overall positive safety record. Both the U.S. Food and Drug Administration and the European Crohn's and Colitis Organization categorize anti-TNF agents as safe during pregnancy. New knowledge regarding the physiologic timing of placental transfer of therapeutic antibody subclasses and pegylated antibody fragments from the mother into the fetus has also helped to allay concerns. This review will examine the present state of knowledge regarding the use of anti-TNFs in pregnant women with IBD.
Authors:
Marwa El Mourabet; Sandra El-Hachem; Janet R Harrison; David G Binion
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current drug targets     Volume:  11     ISSN:  1873-5592     ISO Abbreviation:  Curr Drug Targets     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-03-09     Completed Date:  2010-06-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100960531     Medline TA:  Curr Drug Targets     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  234-41     Citation Subset:  IM    
Affiliation:
UPMC Inflammatory Bowel Disease Center, UPMC Presbyterian Hospital, Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburg School of Medicine, Pittsburgh, PA 15213, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Anti-Inflammatory Agents / adverse effects,  pharmacology,  therapeutic use*
Antibodies, Monoclonal / adverse effects,  pharmacology,  therapeutic use
Female
Humans
Inflammatory Bowel Diseases / complications,  drug therapy*,  physiopathology
Pregnancy
Pregnancy Complications / drug therapy,  physiopathology
Pregnancy Outcome
Severity of Illness Index
Treatment Outcome
Tumor Necrosis Factor-alpha / antagonists & inhibitors*
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Antibodies, Monoclonal; 0/Tumor Necrosis Factor-alpha

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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