Bio treatments for psoriasis during conception and pregnancy

[Fred]

This study tried to evaluate the safety of psoriasis biological treatments in conception and/or pregnancy.

Quote:

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Background:
Biological therapies are effective treatments for psoriasis and are often prescribed to women of child-bearing age.

Objectives:
To evaluate the safety of biological therapy in conception and/or pregnancy.

Methods:
We performed a systematic review of pub med, Medline, Embase and Cochrane databases for multivariate-adjusted studies of women exposed to biologics relevant to the treatment of psoriasis during conception and/or pregnancy.

Results:
We identified four population-based cohort studies involving 1300 women exposed to tumour necrosis factor (TNF)-α inhibitors (TNFi) 3 months prior to or during the first 3 months of pregnancy. These studies showed a trend towards drug-specific harm with TNFi exposure in women with different inflammatory diseases, with an increased risk of congenital malformations [three studies; odds ratio (OR) range 1·32–1·64] and preterm birth (one study; OR 1·69, 95% confidence interval 1·10–2·60). This trend did not reach statistical significance in all studies; study heterogeneity, variation across comparator cohorts, inadequate adjustment for important confounding variables such as co-therapy, and an absence of a common constellation of malformations means there is uncertainty about the causal role of TNFi. No studies specifically addressed the effect of TNFi exposure in psoriasis during conception and/or pregnancy, or of interleukin (IL)-17 and IL-12/23 antagonists in any indication.

Conclusions:
When counselling women these findings must be balanced against the potential impact of untreated severe psoriasis on conception and/or pregnancy and maternal wellbeing; ongoing pharmacovigilance via registries remains essential to address this evidence gap.

Source: onlinelibrary.wiley.com

*Funding:     National Institute for Health Research, Biomedical Research Centre, Guy's and St Thomas’ NHS Foundation Trust, King's College London.

[Turnedlight]

Not something I’d want to risk..

[Kat]

I agree Turnedlight!

Not just what it might do directly to the baby, one would have to worry about infections, should you get one you'd need your body to be able to fight it off so as not to hurt the baby I'd think and would the baby's immune system be compromised? I wouldn't take the chance, but I'm past those years.

[jiml]

To high a risk for my liking ....better to struggle on with the disease than risk hurting the unborn child in my opinion

[Caroline]

Yes, that is also my opinion, no medication at all during pregnancy.

[Maryam]

In my hospital it is standard procedure to stop bio’s during pregnancy and preferably a few months before.

[jiml]

In my hospital it is standard procedure to stop bio’s during pregnancy and preferably a few months before.

A very sensible precaution by them better to be safe than sorry