Anti-TNF therapies and pregnancy: Outcome of 130 pregnancies in the British Society for Rheumatology Biologics Register

Verstappen SMM et al. – No firm conclusions can be drawn about the safety of anti-TNF during pregnancy and, without further evidence, guidelines which suggest these drugs should be avoided at the time of conception cannot yet be changed.

Methods

• Patients categorised according to anti-TNF exposure as follows: (1) exposure to anti-TNF and to MTX and/or leflunomide (LEF) at conception (n=21 pregnancies); (2) exposure to anti-TNF at conception (n=50); (3) exposure to anti-TNF prior to conception (n=59); (4) no exposure to anti-TNF (control group; n=10)

Results

• 88 live births in total of 130 pregnancies reported in patients who received anti-TNF before or during pregnancy
• Rate of spontaneous abortion highest among patients exposed to anti-TNF at time of conception (with MTX/LEF 33% and without MTX/LEF 24%)
• Compared with 17% spontaneous abortions in those with prior exposure to anti-TNF and 10% spontaneous abortions in control group

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