Treatment with immunosuppressive and biologic drugs of pregnant women with systemic rheumatic or autoimmune disease

Jaume Alijotas-Reig, Enrique Esteve-Valverde, Raquel Ferrer-Oliveras

Research output: Contribution to journalReview articleResearchpeer-review

10 Citations (Scopus)

Abstract

© 2016 Elsevier España, S.L.U. Rheumatic and systemic autoimmune diseases occur in women and, to a lesser degree, men of reproductive age. These disorders have to be clinically nonactive before conception, which is usually only possible after anti-inflammatory and immunosuppressive treatment. We must be alert since 50% of pregnancies are unplanned. Physicians should know the embryo-foetal toxicity of these drugs during pregnancy and lactation. This January 2016-updated review allows us to conclude that the majority of immunosuppressives available –anti-TNF inhibitors included– can be used before and during pregnancy, with the exception of cyclophosphamide, methotrexate, mycophenolate and leflunomide. Lactation is permitted with all drugs except methotrexate, leflunomide, mycophenolate and cyclophosphamide. Although data on abatacept, belimumab, rituximab, tocilizumab and anakinra are scant, preliminary reports agree on their safety during pregnancy and, probably, lactation. Cyclophosphamide and sulfasalazine apart, no negative effects on sperm quality, or embryo-foetal anomalies in men treated with immunosuppressives have been described.
Original languageEnglish
Pages (from-to)352-360
JournalMedicina Clinica
Volume147
Issue number8
DOIs
Publication statusPublished - 21 Oct 2016

Keywords

  • Adverse effects
  • Anti-inflammatory drugs
  • Anti-TNF-α
  • Autoimmune diseases
  • Biologics
  • Immunosuppressive
  • Lactation
  • Pregnancy

Fingerprint Dive into the research topics of 'Treatment with immunosuppressive and biologic drugs of pregnant women with systemic rheumatic or autoimmune disease'. Together they form a unique fingerprint.

Cite this