Document Detail


Treatment with biologics of pregnant patients with rheumatic diseases.
MedLine Citation:
PMID:  21346578     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Due to limited human pregnancy experience safety issues in regard to children exposed antenatally to biological drugs are still under debate. A survey of new published experience on biological agents during pregnancy is necessary to assist clinicians with adequate counseling and management of patients who desire children.
RECENT FINDINGS: No controlled study has been published on use of TNFα inhibitors, rituximab, abatacept, tocilizumab or anakinra in pregnancy during the years 2009-2010. New case reports confirm that all monoclonal antibodies expose the child to the full adult dose when administered in late pregnancy with a risk for adverse effects in the newborn and perinatally. Data from a drug registry show that preconceptional and early first-trimester use of rituximab appears to confer no serious side effect to the child. Case reports on abatacept, tocilizumab or anakinra in pregnancy are not conclusive.
SUMMARY: 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.
Authors:
Monika Ostensen; Frauke Förger
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current opinion in rheumatology     Volume:  23     ISSN:  1531-6963     ISO Abbreviation:  Curr Opin Rheumatol     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-03-30     Completed Date:  2011-08-12     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  9000851     Medline TA:  Curr Opin Rheumatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  293-8     Citation Subset:  IM    
Affiliation:
Pregnancy Research Unit, Department of Rheumatology, Clinical Immunology and Allergology, University Hospital and University of Berne, Berne, Switzerland. monika.ostensen@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Animals
Antibodies, Monoclonal / adverse effects*,  pharmacokinetics
Antibodies, Monoclonal, Humanized
Antibodies, Monoclonal, Murine-Derived / adverse effects
Antirheumatic Agents / adverse effects*,  pharmacokinetics
Biological Agents / adverse effects*,  pharmacokinetics
Child
Female
Humans
Immunoconjugates / adverse effects
Interleukin 1 Receptor Antagonist Protein / adverse effects
Male
Maternal-Fetal Exchange
Pregnancy
Pregnancy Complications / metabolism,  therapy*
Rheumatic Diseases / complications*,  metabolism,  therapy*
Spermatogenesis / drug effects
Tumor Necrosis Factor-alpha / antagonists & inhibitors
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Antibodies, Monoclonal, Murine-Derived; 0/Antirheumatic Agents; 0/Biological Agents; 0/Immunoconjugates; 0/Interleukin 1 Receptor Antagonist Protein; 0/Tumor Necrosis Factor-alpha; 0/rituximab; 0/tocilizumab; 7D0YB67S97/abatacept

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


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