Pregnancy and medications for inflammatory bowel disease: An updated narrative review

Article Gastroenterology & Hepatology

European Crohn's and Colitis Guidelines on Sexuality, Fertility, Pregnancy, and Lactation

Joana Torres et al.

JOURNAL OF CROHNS & COLITIS (2023)

Review Gastroenterology & Hepatology

Biologics for Inflammatory Bowel Disease and Their Safety Pregnancy: A Systematic Review and Meta-analysis

Ole Haagen Nielsen et al.

Summary: Adverse pregnancy outcomes among pregnant IBD women using biologics are comparable with that of the general population.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2022)

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Article Medicine, Research & Experimental

MANTA and MANTA-RAy: Rationale and Design of Trials Evaluating Effects of Filgotinib on Semen Parameters in Patients with Inflammatory Diseases

Wayne J. G. Hellstrom et al.

Summary: The MANTA and MANTA-RAy studies were designed to investigate the potential impacts of filgotinib on semen parameters in men with active inflammatory diseases. These studies included strict methodology and extensive analysis of secondary/exploratory measures for conclusions.

ADVANCES IN THERAPY (2022)

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Review Gastroenterology & Hepatology

Pregnancy outcomes following periconceptional or gestational exposure to ustekinumab: Review of cases reported to the manufacturer's global safety database

Uma Mahadevan et al.

Summary: This study evaluated the pregnancy outcomes of patients exposed to ustekinumab during pregnancy. The results showed that the rates of adverse pregnancy outcomes or congenital anomalies with ustekinumab exposure were similar to those reported for the general population in the US, indicating no increased risk associated with maternal or paternal exposure to ustekinumab.

ALIMENTARY PHARMACOLOGY & THERAPEUTICS (2022)

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Article Gastroenterology & Hepatology

Serious Infections in Children Born to Mothers With Inflammatory Bowel Disease With In Utero Exposure to Thiopurines and Anti-Tumor Necrosis Factor

Antoine Meyer et al.

Summary: This study compared the risk of serious infections in children with in utero exposure to thiopurines and/or anti-TNF born to mothers with inflammatory bowel disease (IBD). The results showed that in the first 5 years of life, children exposed to thiopurine monotherapy and anti-TNF monotherapy had similar risks of serious infections compared to unexposed children, while children exposed to combination therapy had a higher risk.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2022)

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Article Obstetrics & Gynecology

Pregnant women with immune mediated inflammatory diseases who discontinue biologics have higher rates of disease flare

Kenneth D. Allen et al.

Summary: This study aimed to evaluate the differences between pregnant women with immune mediated inflammatory diseases (IMIDs) who were treated with biologic agents during pregnancy and those who were not. The results showed that patients who continued biologic therapy during pregnancy had increased risks of major infection, hospital admission, glucocorticoid use, and post-partum disease flare within 6 months, without significant changes in maternal or neonatal outcomes.

ARCHIVES OF GYNECOLOGY AND OBSTETRICS (2022)

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Review Pharmacology & Pharmacy

Pregnancy and neonatal outcomes in women receiving calcineurin inhibitors: A systematic review and meta-analysis

Shintaro Akiyama et al.

Summary: This systematic review and meta-analysis examined the effects of calcineurin inhibitors (CNIs) on pregnancy and neonatal outcomes. The results showed that pregnant women receiving CNIs had higher mortality rates than the general population, making their pregnancies high risk. Preterm delivery and low birth weight were primarily attributed to preeclampsia, which was associated with older maternal age, prepregnancy hypertension, and cyclosporine use.

BRITISH JOURNAL OF CLINICAL PHARMACOLOGY (2022)

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Review Gastroenterology & Hepatology

Risk Factors for Postpartum Disease Activity in Women With Inflammatory Bowel Disease: A Systematic Review and Meta-analysis

Gurpreet Malhi et al.

Summary: This study found that complicated Crohn's disease, active disease during conception and pregnancy, and de-escalation of biologics during pregnancy or after delivery are associated with postpartum disease activity in women with IBD.

INFLAMMATORY BOWEL DISEASES (2022)

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Article Medicine, General & Internal

Upadacitinib as induction and maintenance therapy for moderately to severely active ulcerative colitis: results from three phase 3, multicentre, double-blind, randomised trials

Silvio Danese et al.

LANCET (2022)

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Article Gastroenterology & Hepatology

Safety of Ustekinumab and Vedolizumab During Pregnancy-Pregnancy, Neonatal, and Infant Outcome: A Prospective Multicentre Study

Katarina Mitrova et al.

Summary: The safety of ustekinumab and vedolizumab treatment during pregnancy was evaluated in this study. The outcomes of pregnancy and postnatal infants were found to be favorable. Ustekinumab had a similar infant-to-maternal drug level ratio, while vedolizumab had an inverse ratio compared to anti-TNF preparations.

JOURNAL OF CROHNS & COLITIS (2022)

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Review Chemistry, Medicinal

Evaluating Upadacitinib in the Treatment of Moderate-to-Severe Active Ulcerative Colitis: Design, Development, and Potential Position in Therapy

Maria Napolitano et al.

Summary: Upadacitinib is an oral drug that has been approved for the treatment of rheumatoid arthritis, atopic dermatitis, and psoriatic arthritis. It has also shown efficacy in treating moderate-to-severe ulcerative colitis. The drug has a reliable safety profile.

DRUG DESIGN DEVELOPMENT AND THERAPY (2022)

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Article Gastroenterology & Hepatology

Ustekinumab during pregnancy in patients with inflammatory bowel disease: a prospective multicentre cohort study

Irit Avni-Biron et al.

Summary: Pregnant patients with IBD treated with UST demonstrated favorable pregnancy and neonatal outcomes that were comparable with those in patients treated with anti-TNF or other therapy.

ALIMENTARY PHARMACOLOGY & THERAPEUTICS (2022)

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Article Medicine, General & Internal

Benefits and Risks Associated With Continuation of Anti-Tumor Necrosis Factor After 24 Weeks of Pregnancy in Women With Inflammatory Bowel Disease A Nationwide Emulation Trial

Antoine Meyer et al.

Summary: This study evaluated the benefits and risks of continuing anti-tumor necrosis factor (anti-TNF) treatment after 24 weeks of pregnancy for women with inflammatory bowel diseases (IBDs) and their offspring. The results showed that continuation of anti-TNF after 24 weeks of pregnancy decreased the frequency of maternal IBD relapse and prematurity, while it had no effect on stillbirths, small weight for gestational age births, and serious infections in the offspring.

ANNALS OF INTERNAL MEDICINE (2022)

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Review Pharmacology & Pharmacy

Ozanimod: A Review in Ulcerative Colitis

Julia Paik

Summary: Ozanimod is the first sphingosine-1-phosphate receptor (S1PR) modulator approved for the treatment of moderately to severely active ulcerative colitis. It has shown effectiveness in inducing and maintaining remission in adults with this condition, with manageable or transient adverse events. This expands the treatment options for patients with ulcerative colitis.

DRUGS (2022)

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Article Gastroenterology & Hepatology

Factors Associated with Inflammatory Bowel Disease Flare During Pregnancy Among Women with Preconception Remission

Amihai Rottenstreich et al.

Summary: This study found that women with ulcerative colitis are more likely to experience disease flare during pregnancy, while prior IBD-related surgery and the use of biologic therapy are independently protective factors against relapse in women with quiescent disease at conception.

DIGESTIVE DISEASES AND SCIENCES (2021)

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Article Gastroenterology & Hepatology

Pregnancy and Neonatal Outcomes After Fetal Exposure to Biologics and Thiopurines Among Women With Inflammatory Bowel Disease

Uma Mahadevan et al.

Summary: The study found that exposure to biologic, thiopurine, or combination therapy during pregnancy did not increase adverse maternal or fetal outcomes, and these treatments can be continued throughout pregnancy for women with IBD to maintain disease control.

GASTROENTEROLOGY (2021)

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Review Biochemistry & Molecular Biology

The Role of Tumor Necrosis Factor Alpha (TNF-α) in Autoimmune Disease and Current TNF-α Inhibitors in Therapeutics

Dan-in Jang et al.

Summary: TNF-α was originally identified as a factor causing tumor necrosis but has also been recognized as a pathological component of autoimmune diseases. Its signaling pathways play important roles in cellular responses, and inappropriate activation can lead to chronic inflammation and autoimmune diseases. TNF-α inhibitors have been developed as effective therapeutic tools for various autoimmune diseases.

INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES (2021)

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Article Clinical Neurology

Ozanimod in relapsing multiple sclerosis: Pooled safety results from the clinical development program

Krzysztof W. Selmaj et al.

Summary: This study conducted an integrated safety analysis of extended exposure to ozanimod in RMS participants, showing no new safety concerns in patients with long-term exposure to the drug and consistent results with phase 3 trials.

MULTIPLE SCLEROSIS AND RELATED DISORDERS (2021)

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Article Gastroenterology & Hepatology

Vedolizumab clearance in neonates, susceptibility to infections and developmental milestones: a prospective multicentre population-based cohort study

Mette Julsgaard et al.

Summary: This study investigated the clearance of vedolizumab in newborns after intrauterine exposure, finding rapid clearance and no correlation with infection risk during the first year of life. Continuation of vedolizumab throughout pregnancy was deemed safe.

ALIMENTARY PHARMACOLOGY & THERAPEUTICS (2021)

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Article Gastroenterology & Hepatology

Comparative study of pregnancy outcomes in women with inflammatory bowel disease treated with thiopurines and/or anti-TNF: a French nationwide study 2010-2018

Antoine Meyer et al.

Summary: A study using the French national health database found that pregnancies exposed to thiopurines were more likely to result in stillbirths, preterm births, and large for gestational age infants compared to pregnancies exposed to anti-TNF or unexposed pregnancies. In contrast, pregnancies exposed to anti-TNF monotherapy showed no association with adverse outcomes.

ALIMENTARY PHARMACOLOGY & THERAPEUTICS (2021)

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Review Immunology

Pregnancy and neonatal outcomes in women with immune mediated inflammatory diseases exposed to anti-tumor necrosis factor-a during pregnancy: A systemic review and meta-analysis

Liana Barenbrug et al.

Summary: The use of anti-TNF alpha agents during pregnancy in women with immune mediated inflammatory diseases, such as IBD, RA, and PS, is associated with an increased risk of preterm birth and infections in newborns, particularly for women with IBD. However, there was no increased risk for adverse pregnancy outcomes in women with RA and PS. Vaccination in children exposed to anti-TNF alpha seems to be safe and important in reducing the risk of infections.

JOURNAL OF AUTOIMMUNITY (2021)

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Review Gastroenterology & Hepatology

Systematic review and meta-analysis: Safety of vedolizumab during pregnancy in patients with inflammatory bowel disease

Conor Bell et al.

Summary: The study showed that pregnancies of women with inflammatory bowel disease exposed to vedolizumab may have increased adverse outcomes, including preterm births and early loss of pregnancy. However, these findings may be confounded by disease activity, and further prospective cohort studies are needed to confirm these results.

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY (2021)

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Article Medicine, General & Internal

Filgotinib as induction and maintenance therapy for ulcerative colitis (SELECTION): a phase 2b/3 double-blind, randomised, placebo-controlled trial

Brian G. Feagan et al.

Summary: The study assessed the efficacy and safety of filgotinib in treating ulcerative colitis, with the results showing that 200 mg of filgotinib was more effective than placebo in inducing and maintaining clinical remission.

LANCET (2021)

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Review Gastroenterology & Hepatology

The Influence of Disease Activity on Pregnancy Outcomes in Women With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Min-A Kim et al.

Summary: Active inflammatory bowel disease during conception and pregnancy is associated with an increased risk of adverse pregnancy outcomes, suggesting that pregnancy should be planned when the disease is inactive and continuous disease control is important during pregnancy.

JOURNAL OF CROHNS & COLITIS (2021)

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Review Pharmacology & Pharmacy