Prolonged Persistence of Adalimumab Transferred From Mother to Infant During Pregnancy
Authors: Remi Labetoulle, Xavier Roblin, Stéphane Paul
Journal: Annals of Internal Medicine (2018)

Letters3 July 2018Prolonged Persistence of Adalimumab Transferred From Mother to Infant During PregnancyRemi Labetoulle, MSc, Xavier Roblin, MD, PhD, and Stéphane Paul, PhDRemi Labetoulle, MScUniversity Hospital of Saint Etienne, Saint Priest en Jarez, France (R.L., X.R., S.P.), Xavier Roblin, MD, PhDUniversity Hospital of Saint Etienne, Saint Priest en Jarez, France (R.L., X.R., S.P.), and Stéphane Paul, PhDUniversity Hospital of Saint Etienne, Saint Priest en Jarez, France (R.L., X.R., S.P.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0629 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Some pregnant women with inflammatory bowel disease benefit from treatment with a monoclonal antibody directed against tumor necrosis factor-α, such as infliximab or adalimumab. However, these antibodies are actively transferred across the placenta so that fetal levels are higher than maternal levels, and concerns have been raised about possible effects on the fetus or newborn. These medications are generally considered safe in pregnancy, but information is limited. For example, after bacille Calmette–Guérin vaccination, an infant aged 4.5 months born to a mother receiving infliximab died of bacille Calmette–Guérin infection (1). Because of this uncertainty, decisions about discontinuing therapy with ...References1. Cheent K, Nolan J, Shariq S, Kiho L, Pal A, Arnold J. Case report: fatal case of disseminated BCG infection in an infant born to a mother taking infliximab for Crohn's disease. J Crohns Colitis. 2010;4:603-5. [PMID: 21122568] doi:10.1016/j.crohns.2010.05.001 CrossrefMedlineGoogle Scholar2. vanderWoude CJ, Ardizzone S, Bengtson MB, Fiorino G, Fraser G, Katsanos K, et al; European Crohn's and Colitis Organization. The second European evidenced-based consensus on reproduction and pregnancy in inflammatory bowel disease. J Crohns Colitis. 2015;9:107-24. [PMID: 25602023] CrossrefMedlineGoogle Scholar3. Julsgaard M, Christensen LA, Gibson PR, Gearry RB, Fallingborg J, Hvas CL, et al. Concentrations of adalimumab and infliximab in mothers and newborns, and effects on infection. Gastroenterology. 2016;151:110-9. [PMID: 27063728] doi:10.1053/j.gastro.2016.04.002 CrossrefMedlineGoogle Scholar4. Dubinsky M, Abraham B, Mahadevan U. Management of the pregnant IBD patient. Inflamm Bowel Dis. 2008;14:1736-50. [PMID: 18626967] doi:10.1002/ibd.20532 CrossrefMedlineGoogle Scholar5. Mahadevan U, Cucchiara S, Hyams JS, Steinwurz F, Nuti F, Travis SP, et al. The London Position Statement of the World Congress of Gastroenterology on Biological Therapy for IBD with the European Crohn's and Colitis Organisation: pregnancy and pediatrics. Am J Gastroenterol. 2011;106:214-23. [PMID: 21157441] doi:10.1038/ajg.2010.464 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University Hospital of Saint Etienne, Saint Priest en Jarez, France (R.L., X.R., S.P.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0629.This article was published at Annals.org on 6 March 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byOpportunities and Challenges for PBPK Model of mAbs in Paediatrics and PregnancyOversight and Management of Women with Psoriasis in Childbearing AgeECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel DiseaseUse of medications during pregnancy and breastfeeding for Crohn's disease and ulcerative colitisIntrauterine Exposure to Biologics in Inflammatory Autoimmune Diseases: A Systematic ReviewEffect of biologicals and JAK inhibitors during pregnancy on health-related outcomes in children of women with inflammatory bowel diseaseThe use of biologics and small molecules in pregnant patients with rheumatic diseasesPregnant women with inflammatory bowel disease: the effects of biologicals on pregnancy, outcome of infants, and the developing immune system 3 July 2018Volume 169, Issue 1Page: 60-61KeywordsAntibodiesAttentionBirthCrohn's diseaseInfantsMonoclonal antibodiesNecrosisPlacentaPregnancyVaccines ePublished: 6 March 2018 Issue Published: 3 July 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...