The use of biologics and small molecules in pregnant patients with rheumatic diseases.
Identifieur interne : 001150 ( Main/Exploration ); précédent : 001149; suivant : 001151The use of biologics and small molecules in pregnant patients with rheumatic diseases.
Auteurs : Maria Gerosa [Italie] ; Lorenza Maria Argolini [Italie] ; Carolina Artusi [Italie] ; Cecilia Beatrice Chighizola [Italie]Source :
- Expert review of clinical pharmacology [ 1751-2441 ] ; 2018.
Descripteurs français
- KwdFr :
- Animaux, Antirhumatismaux (effets indésirables), Antirhumatismaux (usage thérapeutique), Complications de la grossesse (physiopathologie), Complications de la grossesse (traitement médicamenteux), Facteur de nécrose tumorale alpha (antagonistes et inhibiteurs), Femelle, Grossesse, Humains, Issue de la grossesse, Produits biologiques (effets indésirables), Produits biologiques (usage thérapeutique), Rhumatismes (physiopathologie), Rhumatismes (traitement médicamenteux).
- MESH :
- antagonistes et inhibiteurs : Facteur de nécrose tumorale alpha.
- effets indésirables : Antirhumatismaux, Produits biologiques.
- physiopathologie : Complications de la grossesse, Rhumatismes.
- traitement médicamenteux : Complications de la grossesse, Rhumatismes.
- usage thérapeutique : Antirhumatismaux, Produits biologiques.
- Animaux, Femelle, Grossesse, Humains, Issue de la grossesse.
English descriptors
- KwdEn :
- Animals, Antirheumatic Agents (adverse effects), Antirheumatic Agents (therapeutic use), Biological Products (adverse effects), Biological Products (therapeutic use), Female, Humans, Pregnancy, Pregnancy Complications (drug therapy), Pregnancy Complications (physiopathology), Pregnancy Outcome, Rheumatic Diseases (drug therapy), Rheumatic Diseases (physiopathology), Tumor Necrosis Factor-alpha (antagonists & inhibitors).
- MESH :
- chemical , adverse effects : Antirheumatic Agents, Biological Products.
- chemical , antagonists & inhibitors : Tumor Necrosis Factor-alpha.
- chemical , therapeutic use : Antirheumatic Agents, Biological Products.
- drug therapy : Pregnancy Complications, Rheumatic Diseases.
- physiopathology : Pregnancy Complications, Rheumatic Diseases.
- Animals, Female, Humans, Pregnancy, Pregnancy Outcome.
Abstract
Biological agents have radically changed the prognosis of rheumatic patients. Current evidence demonstrates that tight disease control during pregnancy is mandatory to minimize adverse outcome risk. As the new therapeutic tools are pivotal to maintain appropriate disease activity, it is timely to review available evidence about the safety of biologics and small molecules in pregnancy. Areas covered: A comprehensive literature review has been performed, reporting available data about the passage into breast milk, rate of pregnancy loss and fetal malformations, and long-term complications due to in utero exposure to biological agents and small molecules. Expert commentary: Data about the safety of agents against tumor necrosis factor in pregnancy are reassuring. Even rituximab, tocilizumab, belimumab, ustekinumab, secukinumab, and abatacept have not been associated with an increased rate of fetal abnormalities or adverse pregnancy outcome. Experience with small molecules is too small to draw any conclusion. Even if further data are warranted to define the possible long-term effects of in utero biologic exposure on the infant immune system development, it is reasonable to speculate that in the next future the use of biologics during pregnancy will continue to expand, at least when maternal benefit justifies the potential risk to the fetus.
DOI: 10.1080/17512433.2018.1525293
PubMed: 30227748
Affiliations:
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Experimental Laboratory of Immunorheumatological Researches, Istituto Auxologico Italiano , Milan , Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>c Department of Clinical Sciences and Community Health , University of Milan, Milan, Italy; Experimental Laboratory of Immunorheumatological Researches, Istituto Auxologico Italiano , Milan </wicri:regionArea><wicri:noRegion>Milan </wicri:noRegion></affiliation></author></analytic><series><title level="j">Expert review of clinical pharmacology</title><idno type="eISSN">1751-2441</idno><imprint><date when="2018" type="published">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Animals</term><term>Antirheumatic Agents (adverse effects)</term><term>Antirheumatic Agents (therapeutic use)</term><term>Biological Products (adverse effects)</term><term>Biological Products (therapeutic use)</term><term>Female</term><term>Humans</term><term>Pregnancy</term><term>Pregnancy Complications (drug therapy)</term><term>Pregnancy Complications (physiopathology)</term><term>Pregnancy Outcome</term><term>Rheumatic Diseases (drug therapy)</term><term>Rheumatic Diseases (physiopathology)</term><term>Tumor Necrosis Factor-alpha (antagonists & inhibitors)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Animaux</term><term>Antirhumatismaux (effets indésirables)</term><term>Antirhumatismaux (usage thérapeutique)</term><term>Complications de la grossesse (physiopathologie)</term><term>Complications de la grossesse (traitement médicamenteux)</term><term>Facteur de nécrose tumorale alpha (antagonistes et inhibiteurs)</term><term>Femelle</term><term>Grossesse</term><term>Humains</term><term>Issue de la grossesse</term><term>Produits biologiques (effets indésirables)</term><term>Produits biologiques (usage thérapeutique)</term><term>Rhumatismes (physiopathologie)</term><term>Rhumatismes (traitement médicamenteux)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antirheumatic Agents</term><term>Biological Products</term></keywords><keywords scheme="MESH" type="chemical" qualifier="antagonists & inhibitors" xml:lang="en"><term>Tumor Necrosis Factor-alpha</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antirheumatic Agents</term><term>Biological Products</term></keywords><keywords scheme="MESH" qualifier="antagonistes et inhibiteurs" xml:lang="fr"><term>Facteur de nécrose tumorale alpha</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Pregnancy Complications</term><term>Rheumatic Diseases</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Antirhumatismaux</term><term>Produits biologiques</term></keywords><keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Complications de la grossesse</term><term>Rhumatismes</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Pregnancy Complications</term><term>Rheumatic Diseases</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Complications de la grossesse</term><term>Rhumatismes</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antirhumatismaux</term><term>Produits biologiques</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Animals</term><term>Female</term><term>Humans</term><term>Pregnancy</term><term>Pregnancy Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Animaux</term><term>Femelle</term><term>Grossesse</term><term>Humains</term><term>Issue de la grossesse</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Biological agents have radically changed the prognosis of rheumatic patients. Current evidence demonstrates that tight disease control during pregnancy is mandatory to minimize adverse outcome risk. As the new therapeutic tools are pivotal to maintain appropriate disease activity, it is timely to review available evidence about the safety of biologics and small molecules in pregnancy. Areas covered: A comprehensive literature review has been performed, reporting available data about the passage into breast milk, rate of pregnancy loss and fetal malformations, and long-term complications due to in utero exposure to biological agents and small molecules. Expert commentary: Data about the safety of agents against tumor necrosis factor in pregnancy are reassuring. Even rituximab, tocilizumab, belimumab, ustekinumab, secukinumab, and abatacept have not been associated with an increased rate of fetal abnormalities or adverse pregnancy outcome. Experience with small molecules is too small to draw any conclusion. Even if further data are warranted to define the possible long-term effects of in utero biologic exposure on the infant immune system development, it is reasonable to speculate that in the next future the use of biologics during pregnancy will continue to expand, at least when maternal benefit justifies the potential risk to the fetus.</div></front></TEI><affiliations><list><country><li>Italie</li></country></list><tree><country name="Italie"><noRegion><name sortKey="Gerosa, Maria" sort="Gerosa, Maria" uniqKey="Gerosa M" first="Maria" last="Gerosa">Maria Gerosa</name></noRegion><name sortKey="Argolini, Lorenza Maria" sort="Argolini, Lorenza Maria" uniqKey="Argolini L" first="Lorenza Maria" last="Argolini">Lorenza Maria Argolini</name><name sortKey="Artusi, Carolina" sort="Artusi, Carolina" uniqKey="Artusi C" first="Carolina" last="Artusi">Carolina Artusi</name><name sortKey="Chighizola, Cecilia Beatrice" sort="Chighizola, Cecilia Beatrice" uniqKey="Chighizola C" first="Cecilia Beatrice" last="Chighizola">Cecilia Beatrice Chighizola</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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