4.4 Review

The use of biologic therapy in pregnancy: a gastroenterologist's perspective

Journal

CURRENT OPINION IN RHEUMATOLOGY
Volume 26, Issue 3, Pages 347-353

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/BOR.0000000000000048

Keywords

adalimumab; breastfeeding; certolizumab pegol; inflammatory bowel disease; infliximab; pregnancy

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Funding

  1. Janssen
  2. Abbvie
  3. UCB
  4. Prometheus Labs

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Purpose of reviewInflammatory bowel disease (IBD) often affects women in their peak reproductive years, and therapy is often continued during pregnancy to maintain stable disease activity. Therapeutic options have expanded over the last 2 decades with the advent of new biologic options. It is, therefore, important for the gastroenterologists and other clinicians caring for patients with IBD to understand safety data regarding the treatment options, both biologic and nonbiologic, in pregnant IBD patients.Recent findingsIn general, quality of evidence in this area remains low. However, larger prospective studies are beginning to provide evidence regarding the potential safety of biologics both alone and in conjunction with nonbiologic therapy.SummaryThe majority of treatment options for IBD appears to be of low risk and may often be continued through pregnancy and lactation. Not treating IBD, for example, by discontinuing therapy prior to or with pregnancy, may pose a greater risk to mother and fetus in many cases.

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