RESEARCH - Drug insight: anti-TNF therapy for inflammatory arthropathies during reproduction, pregnancy and lactation

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Nat Clin Pract Rheumatol. 2007 Mar;3(3):156-64.

Drug insight: Anti-tumor necrosis factor therapy for inflammatory

arthropathies during reproduction, pregnancy and lactation.

Skomsvoll JF, Wallenius M, Koksvik HS, Rødevand E, Salvesen KA,

Spigset O, Kvien TK.

Department of Obstetrics, Trondheim University Hospital, Trondheim, Norway.

Tumor necrosis factor (TNF) antagonists are widely used to reduce

disease activity and joint damage, and to improve health-related

quality of life in patients suffering from rheumatoid arthritis,

ankylosing spondylitis, or psoriatic arthritis. To date, no increased

risk of embryotoxicity or teratogenicity, or adverse pregnancy outcome

(such as birth defects, premature birth, and low birth weight) has

been reported in patients with inflammatory arthropathies treated with

anti-TNF therapy, compared with the general population. However, the

available data are limited, and methotrexate, which is commonly used

in combination with anti-TNF drugs, is teratogenic. Until more data

are available, no firm conclusions can be reached regarding the safety

of anti-TNF therapy in pregnancy. Nevertheless, in selected cases

where there is high disease activity, anti-TNF therapy might be

recommended, depending on the results of individual risk-benefit

analyses. Fully informed consent from the mother is needed in such

cases. Anti-TNF agents are not usually used during lactation, although

the risk of toxicity is probably negligible.

PMID: 17334338

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed & Cmd=ShowDetailView & TermToSear\

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