Details

Autor(en) / Beteiligte

• Zelinkova, Zuzana
• van der Ent, Cokkie
• Bruin, Karlien F
• van Baalen, Onno
• Vermeulen, Hestia G
• Smalbraak, Herman J.T
• Ouwendijk, Rob J
• Hoek, Aad C
• van der Werf, Sjoerd D
• Kuipers, Ernst J
• van der Woude, C. Janneke

Titel

Effects of Discontinuing Anti–Tumor Necrosis Factor Therapy During Pregnancy on the Course of Inflammatory Bowel Disease and Neonatal Exposure

Ist Teil von

• Clinical gastroenterology and hepatology, 2013-03, Vol.11 (3), p.318-321

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2013

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Background & Aims We assessed the course of inflammatory bowel disease (IBD) among pregnant women who stopped taking anti–tumor necrosis factor (TNF) agents. We also analyzed levels of anti-TNF agents in cord blood samples. Methods We followed 31 pregnancies in 28 women with IBD between April 2006 and April 2011 who were treated with anti-TNF agents (18 received infliximab, and 13 received adalimumab) during pregnancy. We used enzyme-linked immunosorbent assays to measure levels of anti-TNF agents in cord blood collected from 18 newborns (12 whose mothers took infliximab, and 6 whose mothers took adalimumab). Results Among the patients taking infliximab, 12 (71%) discontinued treatment before gestational week 30; all patients remained in remission. All the patients taking adalimumab discontinued treatment before gestational week 30; two patients had relapses of IBD. There were 28 live births, 1 miscarriage among patients taking infliximab (at gestational week 6), and 2 miscarriages among patients taking adalimumab (at weeks 6 and 8); there were no congenital malformations. The mean cord blood level of infliximab was 6.4 ± 1.6 μg/mL; it was significantly lower among women who received the drug 10 weeks or less before delivery (2.8 ± 1.1 μg/mL) than those who received infliximab closer to delivery (10 ± 2.3 μg/mL; P = .02). Adalimumab was detected in 5 samples of cord blood (mean concentration, 1.7 ± 0.4 μg/mL); 1 cord blood sample from a woman who discontinued the treatment at gestational week 22 had an undetectable level of the drug. Conclusions Discontinuation of anti-TNF therapy appears to be safe for pregnant women with quiescent IBD. However, these drugs are still detected in cord blood samples.