Within the last two decades, a type of medicine known as a biologic became popular for the treatment of autoimmune disease such as lupus, or ankylosing spondylitis. The treatments work by targeting inflammatory cytokines known to be part of the abnormal immune response. That much is known. What remained unknown was whether these drugs were safe for use during pregnancy. Keep reading to learn more, or follow the original story here for additional details.
A new study, published in the Annals of the Rheumatic Diseases journal declares biologics safe for use by pregnant women. More specifically, the study states that there are no significant risks associated with the use of biologics during pregnancy (click here to find the study in full).
One of the reasons discussion exists around biologics and pregnancy is a molecule known as TNF-alpha.
TNF-alpha (or tumor necrosis factor alpha) is one of the molecules which regulate abnormal autoimmune response in many autoimmune disease. Examples include rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn’s, inflammatory bowel disease, and pediatric and adult ulcerative colitis. TNF-alpha is also involved in pregnancy. High levels of it during labor often results in preterm delivery.
Since biologics interact with molecules like TNF-alpha there seemed reason enough to be concerned about complications during pregnancy.
Until the team at University of British Columbia decided to investigate, no conclusive research, however, had been done on the topic.
Researchers examined records from women in their Canadian province who became pregnant and were known to have autoimmune diseases. OF the group studied, most were diagnosed with rheumatoid arthritis or inflammatory bowel disease. 6,218 women were studied during research, and among them 8,607 pregnancies.
The group consisted of 109 women with 120 pregnancies treated with biologics. Treatment extended up to three months before pregnancy or during pregnancy. Another group consisted of 584 women bearing 600 pregnancies. This second group experienced no exposure to biologics.
Of the 109 women treated with biologics the treatments used bore incredible consistency. Remicade, Enbrel, and Humira made up 94% of the biologics within the treatment group.
Between the two groups – those treated with biologics, and those without – researchers deemed the difference in preterm births insignificant. For women with biologics the total came to 18%. Those without showed 16%. Similar results occurred when comparing the rate of smaller than average babies. The group exposed to biologics showed 9%, while the control group totaled 10%.
In the words of the researchers: “Altogether, we found no association between biologics use before or during pregnancy and preterm delivery or SGA [smaller than normal] births in women with autoimmune diseases, compared with those who had comparable propensity to receive biologics during that time but did not.”
Researchers conclude by confirming that they believe biologics to be a safe form of treatment for women with the autoimmune diseases they studied.