title: The Efficacy and Safety of Cyclosporin A in Pregnant Patients with Systemic Autoimmune Diseases.
abstract: Cyclosporin A (CYS A) is an immunosuppressant agent administered in autoimmune diseases, and its use during pregnancy and lactation is a debated topic.
  
  
  
  The demographic characteristics, the activity of the underlying disease, and the onset of fetal-maternal complications have been investigated in 21 consecutive patients (2 RA, 14 SLE, 2 PA, 1 SjS, 1 DM, 1 Churg-Strauss vasculitis), treated with CYS A throughout 29 gestations. A subanalysis of the SLE group was performed.
  
  
  
  We recorded a live birth rate of 86.2%. The median gestational age at birth was 38.2 weeks. The prevalence of maternal-fetal complications showed no differences with general population. Disease flares appeared in 4% of patients during gestation and in 12% during puerperium.
  
  
  
  We found no evidence justifying the suspension of CYS A when a pregnancy occurs. The drug does not appear to promote maternal-fetal complications and should be continued in patients who benefit from therapy. Data regarding breast-feeding during therapy are still scarce, but no evidence of toxicity has emerged.
authors.affiliation: Rheumatology and Clinical Immunology, Spedali Civili and University of Brescia, Brescia, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Reggia
authors.affiliation: Rheumatology and Clinical Immunology, Spedali Civili and University of Brescia, Brescia, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Bazzani
authors.affiliation: Rheumatology and Clinical Immunology, Spedali Civili and University of Brescia, Brescia, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Andreoli
authors.affiliation: Neonatology and Neonatal Intensive Care Unit, Spedali Civili and University of Brescia, Brescia, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Motta
authors.affiliation: Obstetrics and Gynecology, Spedali Civili and University of Brescia, Brescia, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lojacono
authors.affiliation: Obstetrics and Gynecology, Spedali Civili and University of Brescia, Brescia, Italy.
authors.forename: Sonia
authors.initials: S
authors.lastname: Zatti
authors.affiliation: Obstetrics and Gynecology, Spedali Civili and University of Brescia, Brescia, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Ramazzotto
authors.affiliation: Functional Rieducation, San Rocco Clinic, Brescia, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Nuzzo
authors.affiliation: Rheumatology and Clinical Immunology, Spedali Civili and University of Brescia, Brescia, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Tincani
mesh_terms: D000293:Adolescent; D000328:Adult; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000453:epidemiology*; D001942:Breast Feeding; D016572:Cyclosporine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007558:Italy / Q000453:epidemiology; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D015995:Prevalence; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine
keywords: Autoimmune diseases; cyclosporin A; efficacy; pregnancy; safety