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

International Journal of Molecular Sciences
Cæcilie Bachdal JohansenSimon Francis Thomsen

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 Hea...Continue Reading

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Apr 20, 2019·Giornale Italiano Di Dermatologia E Venereologia : Organo Ufficiale, Società Italiana Di Dermatologia E Sifilografia·Clara De SimoneFrancesca Prignano
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Jul 31, 2019·International Journal of Women's Dermatology·Alice B GottliebJenny E Murase

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Methods Mentioned

BETA
cesarean section
SGA

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