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The Use and Safety of TNF Inhibitors during Pregnancy in Women with Psoriasis: A Review

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@article{0791846ec3bf4331809bd801ad71aeed,
title = "The Use and Safety of TNF Inhibitors during Pregnancy in Women with Psoriasis: A Review",
abstract = "Psoriasis is a chronic immune-mediated inflammatory disease affecting women of childbearing potential. Biologic agents, notably Tumor Necrosis Factor inhibitors (TNFi), are the only current non-contraindicated systemic treatment option during pregnancy. TNFi comprised of complete immunoglobulin G (IgG) antibodies antibodies (adalimumab, golimumab, and infliximab) actively cross the placenta from the second trimester and are detectable in the child up to one year postpartum. Data on safety of TNFi are conflicting; however a trend towards drug-specific harm has been reported, with increased risk of congenital malformations and preterm birth. TNFi exposure may alter the immune system of the infant towards hypersensitivity and reduced response to intracellular infections. Confounding by indication should be considered, as chronic inflammatory disease itself may pose a risk of adverse pregnancy outcomes. The quality of the current evidence is very low and no studies specifically address TNFi safety in women with psoriasis. Nonetheless, risks associated with TNFi treatment must be balanced against the as-yet uncertain risk of adverse outcomes in infants born to women with severe psoriasis. We searched PubMed using Medical Subject Headings (MeSH) terms and identified relevant studies and guidelines. Herein, we present the current knowledge of the use and safety of TNFi during pregnancy in women with psoriasis.",
keywords = "Animals, Dermatologic Agents/therapeutic use, Female, Humans, Immunoglobulin G/metabolism, Infant, Newborn, Inflammation/drug therapy, Nervous System Malformations/drug therapy, Pregnancy, Psoriasis/drug therapy",
author = "Johansen, {C{\ae}cilie Bachdal} and Espen Jimenez-Solem and Ann Haerskjold and Sand, {Freja L{\ae}rke} and Thomsen, {Simon Francis}",
year = "2018",
month = "5",
day = "3",
doi = "10.3390/ijms19051349",
language = "English",
volume = "19",
journal = "International Journal of Molecular Sciences",
issn = "1661-6596",
publisher = "Molecular Diversity Preservation International (M D P I)",
number = "5",

}

RIS

TY - JOUR

T1 - The Use and Safety of TNF Inhibitors during Pregnancy in Women with Psoriasis

T2 - A Review

AU - Johansen, Cæcilie Bachdal

AU - Jimenez-Solem, Espen

AU - Haerskjold, Ann

AU - Sand, Freja Lærke

AU - Thomsen, Simon Francis

PY - 2018/5/3

Y1 - 2018/5/3

N2 - Psoriasis is a chronic immune-mediated inflammatory disease affecting women of childbearing potential. Biologic agents, notably Tumor Necrosis Factor inhibitors (TNFi), are the only current non-contraindicated systemic treatment option during pregnancy. TNFi comprised of complete immunoglobulin G (IgG) antibodies antibodies (adalimumab, golimumab, and infliximab) actively cross the placenta from the second trimester and are detectable in the child up to one year postpartum. Data on safety of TNFi are conflicting; however a trend towards drug-specific harm has been reported, with increased risk of congenital malformations and preterm birth. TNFi exposure may alter the immune system of the infant towards hypersensitivity and reduced response to intracellular infections. Confounding by indication should be considered, as chronic inflammatory disease itself may pose a risk of adverse pregnancy outcomes. The quality of the current evidence is very low and no studies specifically address TNFi safety in women with psoriasis. Nonetheless, risks associated with TNFi treatment must be balanced against the as-yet uncertain risk of adverse outcomes in infants born to women with severe psoriasis. We searched PubMed using Medical Subject Headings (MeSH) terms and identified relevant studies and guidelines. Herein, we present the current knowledge of the use and safety of TNFi during pregnancy in women with psoriasis.

AB - Psoriasis is a chronic immune-mediated inflammatory disease affecting women of childbearing potential. Biologic agents, notably Tumor Necrosis Factor inhibitors (TNFi), are the only current non-contraindicated systemic treatment option during pregnancy. TNFi comprised of complete immunoglobulin G (IgG) antibodies antibodies (adalimumab, golimumab, and infliximab) actively cross the placenta from the second trimester and are detectable in the child up to one year postpartum. Data on safety of TNFi are conflicting; however a trend towards drug-specific harm has been reported, with increased risk of congenital malformations and preterm birth. TNFi exposure may alter the immune system of the infant towards hypersensitivity and reduced response to intracellular infections. Confounding by indication should be considered, as chronic inflammatory disease itself may pose a risk of adverse pregnancy outcomes. The quality of the current evidence is very low and no studies specifically address TNFi safety in women with psoriasis. Nonetheless, risks associated with TNFi treatment must be balanced against the as-yet uncertain risk of adverse outcomes in infants born to women with severe psoriasis. We searched PubMed using Medical Subject Headings (MeSH) terms and identified relevant studies and guidelines. Herein, we present the current knowledge of the use and safety of TNFi during pregnancy in women with psoriasis.

KW - Animals

KW - Dermatologic Agents/therapeutic use

KW - Female

KW - Humans

KW - Immunoglobulin G/metabolism

KW - Infant, Newborn

KW - Inflammation/drug therapy

KW - Nervous System Malformations/drug therapy

KW - Pregnancy

KW - Psoriasis/drug therapy

U2 - 10.3390/ijms19051349

DO - 10.3390/ijms19051349

M3 - Review

VL - 19

JO - International Journal of Molecular Sciences

JF - International Journal of Molecular Sciences

SN - 1661-6596

IS - 5

ER -

ID: 55741536