Tumour necrosis factor alpha and use of infliximab. Safety during pregnancy.
OBJECTIVE
A 27-year-old patient of mine with rheumatoid arthritis has been treated with infliximab for the last 5 years. She is planning her first pregnancy. How should I advise her regarding use of infliximab during pregnancy, bearing in mind that infliximab substantially improved her medical condition?


CONCLUSIONS
Infliximab (Remicade) has not been tested in pregnant animals because it does not interact with non-human tumour necrosis factor (TNF) alpha. Several case reports describing women who used infliximab during pregnancy do not suggest a strong association with adverse pregnancy outcomes. More studies are required to determine infliximab's safety during pregnancy.
Shrim
Alan
A
Motherisk Program, Hospital for Sick Children, Toronto, Ont.
Koren
Gideon
G
D000014:Abnormalities, Drug-Induced / Q000517:prevention & control*; D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000069285:Infliximab; D018811:Maternal Exposure; D011247:Pregnancy; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab