Pregnancy and foetal outcomes following anti-tumor necrosis factor alpha therapy: A prospective multicentre study - 06/03/17
, Antonia Calligaro a, Emma Di Poi b, Susanna Peccatori c, Maria Favaro a, Teresa Del Ross a, Roberta Ramonda a, Chiara Grava d, Bernd Raffeiner a, Paola Ravagni c, Salvatore De Vita b, Amelia Ruffatti aBienvenue sur EM-consulte, la référence des professionnels de santé.
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Abstract |
Objective |
As many inflammatory rheumatic diseases affect patients in childbearing age, some concern has been expressed about the safety of biologic drugs during pregnancy. This study evaluated the effects of anti-tumor necrosis factor alpha (TNFα) agents on pregnancy/foetal outcomes.
Methods |
Thirty-eight pregnancies were followed prospectively from November 2008 to February 2015. Information about the patients’ exposure to anti-TNFα, disease activity, DMARD therapy, pregnancy/foetal outcomes were registered.
Results |
Twenty-four/38 (71.1%) pregnancies were exposed to anti-TNFα at conception/I trimester, 11/38 (28.9%) prior to conception and 3 (11.1%) following paternal exposure. There were two congenital malformations: one infant (4.2%) was diagnosed with congenital diaphragmatic hernia and obstructive megaureter; the mother was exposed to adalimumab at conception/I trimester. While one foetus (9.1%) showed a trisomy 16, the mother 38 year-old had suspended etanercept 4 weeks before conception. There was no significant difference in pregnancy/foetal outcome between the two groups. Nor were there any significant differences in pregnancy/foetal outcomes in the various groups being treated with different anti-TNFα antagonists. No congenital malformations were found in connection to paternal exposure.
Conclusion |
Study results suggest that anti-TNFα drugs could be safe when administered during conception/I trimester and following paternal exposure.
Le texte complet de cet article est disponible en PDF.Keywords : Pregnancy, Anti-TNFα agents, Foetal outcome, Rheumatoid arthritis, Psoriatic arthritis, Ankylosing spondylitis
Plan
Vol 84 - N° 2
P. 169-173 - mars 2017 Retour au numéro
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