Although guidelines are a great resource for all patients and providers, this study gives us more detailed information to make specific and patient-centered decisions.
Chances in the Tournament
TNFi in Cord Blood takes medication management in pregnancy one step further by looking at the science behind the guidelines and even rocks the boat on some current recommendations. Additionally, it gives us biochemical evidence supporting their safe use during pregnancy.
Our article creates an excellent base for further research on the topic of safe medications during pregnancy and continuously improving recommendations for our patients, both large and small.
Lauren He, MD, is an internal medicine resident at University of Chicago Medicine.
Cuoghi Edens, MD, is an assistant professor of Internal Medicine & Pediatrics, Section of Rheumatology & Pediatric Rheumatology at University of Chicago Medicine.
References
- Gotestam Skorpen C, Hoeltzenbein M, Tincani A, et al. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis. 2016 May;75(5):795–810.
- Ghalandari N, Kemper E, Crijns I. Analysing cord blood levels of TNF inhibitors to validate the EULAR points to consider for TNF inhibitor use during pregnancy. Ann Rheum Dis. 2021 Sep 7;annrheumdis-2021-221036.
- Berkhout LC, I’Ami MJ, Ruwaard J, et al. Dynamics of circulating TNF during adalimumab treatment using a drug-tolerant TNF assay. Sci Transl Med. 2019 Jan 30;11(477):eaat3356.
- Beaulieu DB, Ananthakrishnan AN, Martin C, et al. Use of biologic therapy by pregnant women with inflammatory bowel disease does not affect infant response to vaccines. Clin Gastroenterol Hepatol. 2018 Jan;16(1):99–105.
- De Lorenzo R, Ramirez GA, Punzo D, et al. Neonatal outcomes of children born to mothers on biological agents during pregnancy: State of the art and perspectives. Pharmacol Res. 2020 Feb;152:104583.
- Tsao NW, Lynd LD, Sayre EC, et al. Use of biologics during pregnancy and risk of serious infections in the mother and baby: A Canadian population-based cohort study. BMJ Open. 2019 Feb 20;9(2):e023714.
- Mariette X, Froger F, Abraham B, et al. Lack of placental transfer of certolizumab pegol during pregnancy: Results from CRIB, a prospective, postmarketing, pharmacokinetic study. Ann Rheum Dis. 2018 Feb;77(2):228–233.
- Berthelsen BG, Fjeldsøe-Nielsen H, Nielsen CT, et al. Etanercept concentrations in maternal serum, umbilical cord serum, breast milk and child serum during breastfeeding. Rheumatology (Oxford). 2010 Nov;49(11):2225–2227.
- Sammaritano LR, Bermas BL, Chakravarty EE, et al. 2020 American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal diseases. Arthritis Rheumatol. 2020 Apr;72(4):529–556.
- Mahadevan U, Robinson C, Bernasko N, et al. Inflammatory bowel disease in pregnancy clinical care pathway: A report from the American Gastroenterological Association IBD Parenthood Project Working Group. Gastroenterology. 2019 Apr;156(5):1508–1524.