Anti-TNF Exposure during Pregnancy in Crohn's Disease Patients.

The use of 'biological' drugs that are derived from the IgG antibody, are gaining in popularity.  They are used in many syndromes today and are providing major changes in lifestyle for humans.  These drugs commonly work for all kinds of rheumatic or autoimmune syndromes and provide major lifestyle changes in patients.  Fortunately,  these IgG-type products don't transfer into breastmilk very well and therefore breastfeeding mothers can commonly use these products quite safely.  In pregnant women,  I'd suggest you look at Cimzia,  which we now know does not transfer into the fetus in the last trimester, and doesn't transfer much into breastmilk. (Disclaimer, I was involved in the Cimzia trial. TWH)

 

Case Rep Gastroenterol. 2018 Oct 17;12(3):608-616. doi: 10.1159/000493921. eCollection 2018 Sep-Dec.

Anti-TNF Exposure during Pregnancy in Crohn's Disease Patients.

Silva EFC1, Baima JP1, de Barros JR1, Renosto FL1, de Sibia CF2, Saad-Hossne R2, Sassaki LY1.

Abstract

Inflammatory bowel disease (IBD) affects young people of reproductive age. Therefore, a broad discussion is needed about the possible disease effects in pregnancy, as well as the risks of fetal exposure to the medications used, especially biological therapy. This study aimed to describe the management of 4 Crohn's disease patients who received anti-TNF therapy during pregnancy and present a literature review. We reported 4 cases composed of young women who became pregnant while receiving anti-TNF agents. The patients presented a satisfactory response to the clinical treatment and the pregnancies progressed without complications. We did not observe maternal or embryonic toxicity, or unfavorable outcomes. The available data point to inflammatory activity as the main risk factor for unfavorable gestational evolution to date, and showed anti-TNF therapy to be safe during pregnancy and breastfeeding. However, the benefits and risks must be discussed with the patient and management decisions should be taken on an individual basis.

KEYWORDS:

Anti-TNF therapy; Biological therapy; Crohn's disease; Inflammatory bowel disease; Pregnancy

PMID: 30483038