Document Detail

The London Position Statement of the World Congress of Gastroenterology on Biological Therapy for IBD with the European Crohn's and Colitis Organisation: pregnancy and pediatrics.
MedLine Citation:
PMID:  21157441     Owner:  NLM     Status:  MEDLINE    
Women with inflammatory bowel disease (IBD) have similar rates of fertility to the general population, but have an increased rate of adverse pregnancy outcomes compared with the general population, which may be worsened by disease activity. Infertility is increased in those undergoing ileal pouch-anal anastomosis. Anti-tumor necrosis factor therapy in pregnancy is considered to be low risk and compatible with use during conception in men and women and during pregnancy in at least the first two trimesters. Infliximab (IFX) and certolizumab pegol are also compatible with breastfeeding, but safety data for adalimumab (ADA) are awaited. The safety of natalizumab during pregnancy is unknown. For children with Crohn's disease (CD), IFX is effective at inducing and maintaining remission. Episodic therapy is not as effective as scheduled infusions. Disease duration in children does not appear to affect the efficacy of IFX. IFX promotes growth in prepubertal and early pubertal Crohn's patients. It is also effective for the treatment of extraintestinal manifestations. ADA is effective for children with active CD and for maintaining remission, even if they have lost response to IFX, although there are fewer data. Vaccination of infants exposed to biological therapy in utero should be given at standard schedules during the first 6 months of life, except for live-virus vaccines such as rotavirus. Inactivated vaccines may be safely administered to children with IBD, even when immunocompromised.
Uma Mahadevan; Salvatore Cucchiara; Jeffrey S Hyams; Flavio Steinwurz; F Nuti; Simon P L Travis; William J Sandborn; Jean-Frederio Colombel
Publication Detail:
Type:  Journal Article; Review     Date:  2010-12-14
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  106     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-08     Completed Date:  2011-04-20     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  214-23; quiz 224     Citation Subset:  IM    
Department of Gastroenterology, UCSF Center for Colitis and Crohn's Disease, San Francisco, California 94115, USA.
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MeSH Terms
Anti-Inflammatory Agents / therapeutic use
Antibodies, Monoclonal / therapeutic use
Antibodies, Monoclonal, Humanized
Breast Feeding
Colitis / drug therapy*
Crohn Disease / drug therapy*
Gastrointestinal Agents / therapeutic use*
Immunization Schedule
Immunoglobulin Fab Fragments / therapeutic use
Pediatrics / methods*
Polyethylene Glycols / therapeutic use
Pregnancy Complications / drug therapy*
Pregnancy Outcome
Remission Induction
Tumor Necrosis Factor-alpha / antagonists & inhibitors*
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Gastrointestinal Agents; 0/Immunoglobulin Fab Fragments; 0/Polyethylene Glycols; 0/Tumor Necrosis Factor-alpha; 0/infliximab; 0/natalizumab; UMD07X179E/certolizumab pegol
Comment In:
Am J Gastroenterol. 2011 Feb;106(2):225-7; quiz 228   [PMID:  21301451 ]

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