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The Use and Safety of TNF Inhibitors during Pregnancy in Women with Psoriasis: A Review
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 (I...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5983707/ https://www.ncbi.nlm.nih.gov/pubmed/29751529 http://dx.doi.org/10.3390/ijms19051349 |
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author | Johansen, Cæcilie Bachdal Jimenez-Solem, Espen Haerskjold, Ann Sand, Freja Lærke Thomsen, Simon Francis |
author_facet | Johansen, Cæcilie Bachdal Jimenez-Solem, Espen Haerskjold, Ann Sand, Freja Lærke Thomsen, Simon Francis |
author_sort | Johansen, Cæcilie Bachdal |
collection | PubMed |
description | 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 Headings (MeSH) terms and identified relevant studies and guidelines. Herein, we present the current knowledge of the use and safety of TNFi during pregnancy in women with psoriasis. |
format | Online Article Text |
id | pubmed-5983707 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-59837072018-06-05 The Use and Safety of TNF Inhibitors during Pregnancy in Women with Psoriasis: A Review Johansen, Cæcilie Bachdal Jimenez-Solem, Espen Haerskjold, Ann Sand, Freja Lærke Thomsen, Simon Francis Int J Mol Sci Review 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 Headings (MeSH) terms and identified relevant studies and guidelines. Herein, we present the current knowledge of the use and safety of TNFi during pregnancy in women with psoriasis. MDPI 2018-05-03 /pmc/articles/PMC5983707/ /pubmed/29751529 http://dx.doi.org/10.3390/ijms19051349 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Johansen, Cæcilie Bachdal Jimenez-Solem, Espen Haerskjold, Ann Sand, Freja Lærke Thomsen, Simon Francis The Use and Safety of TNF Inhibitors during Pregnancy in Women with Psoriasis: A Review |
title | The Use and Safety of TNF Inhibitors during Pregnancy in Women with Psoriasis: A Review |
title_full | The Use and Safety of TNF Inhibitors during Pregnancy in Women with Psoriasis: A Review |
title_fullStr | The Use and Safety of TNF Inhibitors during Pregnancy in Women with Psoriasis: A Review |
title_full_unstemmed | The Use and Safety of TNF Inhibitors during Pregnancy in Women with Psoriasis: A Review |
title_short | The Use and Safety of TNF Inhibitors during Pregnancy in Women with Psoriasis: A Review |
title_sort | use and safety of tnf inhibitors during pregnancy in women with psoriasis: a review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5983707/ https://www.ncbi.nlm.nih.gov/pubmed/29751529 http://dx.doi.org/10.3390/ijms19051349 |
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