Professional paper

https://doi.org/10.33004/reumatizam-66-1-2

Biologic therapy and pregnancy – a tertiary center experience

Marija Bakula, ; Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University of Zagreb School of Medicine, Universitiy Hospital Center Zagreb, Croatia
Paula Kilić, ; Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University of Zagreb School of Medicine, Universitiy Hospital Center Zagreb, Croatia
Mislav Cerovec, ; Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University of Zagreb School of Medicine, Universitiy Hospital Center Zagreb, Croatia
Miroslav Mayer, ; Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University of Zagreb School of Medicine, Universitiy Hospital Center Zagreb, Croatia
Branimir Anić ; Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University of Zagreb School of Medicine, Universitiy Hospital Center Zagreb, Croatia

Abstract

Treatment of inflammatory rheumatic diseases and control of disease activity have considerably improved after the introduction of biologic therapy over a decade ago. The safety profile of biologic therapy in the preconception period as well as during pregnancy and lactation is neccessary to consider when planning the treatment of young
female patients. Neither the Food and Drug Administration Agency nor the European Medicines Agency have declared biologic therapy safe during pregnancy. Both the European League Against Rheumatism and the British Society for Rheumatology proposed guidelines for the treatment of female rheumatology patients during pregnancy and lactation, and the American College of Rheumatology is currently developing guidelines for the therapeutic approach during pregnancy. On the other hand, there are numerous publications of pregnancy outcomes in patients treated with biologic therapy, with a small number of adverse effects. We analyzed the modalities of biologic therapy and pregnancy outcomes in patients treated at our Department, during planned and unplanned pregnancies. Our results do not differ from the literature published to date. Among the patients described here, 15 were treated with an inhibitor of tumor necrosis factor-α and one with an IL-6 inhibitor during or just before pregnancy. Only 2 patients stopped biologic therapy in compliance with the guidelines. Of the 16 aforementioned patients, 3 had to undergo medically-induced abortion;
one patient because of a severe fetal malformation and the other two patients because they had bee.

Keywords

Rheumatic diseases – drug therapy; Pregnancy complications – drug therapy; Antirheumatic agents – therapeutic use; Biological products – therapeutic use; Tumor necrosis factor-alpha – antagonists and inhibitors; Antibodies, monoclonal, humanized – therapeutic use; Pregnancy outcome

Hrčak ID:

226240

URI

https://hrcak.srce.hr/226240

Publication date:

16.10.2019.

Article data in other languages: croatian

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