title: Use of TNF-inhibitors and ustekinumab for psoriasis during pregnancy: A patient series.
abstract: From 2002 to 2016 a total of seven women with severe refractory psoriasis were exposed to the TNF-inhibitors infliximab and adalimumab or to the IL12/23 inhibitor ustekinumab during one or more pregnancies. Maternal, fetal or teratogenic toxicity were not detected during pregnancy and puerperium. All pregnancies were uneventful and resulted in delivery of 10 healthy children in total, one of the women is due February 2017. Postpartum, five of the women were lactating, but none of the women or newborns developed adverse reactions. Data on safety of treatment during breastfeeding are sparse, but so far appears to be safe due to the lack of absorption across the gastrointestinal lining. Currently biological therapy with either TNF-inhibitors or ustekinumab is not recommended during pregnancy, however in selected women with severe psoriasis these treatment modalities may be considered.
authors.affiliation: Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark.
authors.forename: Tamara
authors.initials: T
authors.lastname: Lund
authors.affiliation: Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark.|Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Simon Francis
authors.initials: SF
authors.lastname: Thomsen
mesh_terms: D000068879:Adalimumab / Q000009:adverse effects / Q000627:therapeutic use; D000328:Adult; D001942:Breast Feeding; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D000069285:Infliximab / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011256:Pregnancy Outcome; D011565:Psoriasis / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D000069549:Ustekinumab / Q000009:adverse effects / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D003879:Dermatologic Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000069549:Ustekinumab; D000068879:Adalimumab
keywords: biologics; inflammatory disorders; pharmacology; psoriasis; therapy-systemic