Psoriasis and pregnancy in the biologic era, a feared scenario. What do we do now?
Tirelli Luciana LauraPaula C LunaEcheverría CristinaMargarita LarraldePublished in: Dermatologic therapy (2019)
Psoriasis is a chronic, multifactorial inflammatory disease; its clinical severity can vary widely. Treatment of severe cases during pregnancy is of special interest. To date there is scarce information available and most data comes from other medical specialties that use similar treatments. Immunosuppressors are strongly discouraged during pregnancy and breastfeeding. Amongst biologic agents, anti-TNFα having been the longest on the market has allowed for the most experience. It is known that transplacental transport of these drugs does not occur until gestational week 22, once organogenesis is completed. Within this group certolizumab pegol, seems to be the safest choice, as its molecular structure does not cross the placental barrier. Beyond pregnancy, it is important to take into account these drugs' half-life and passage to breast milk, as well as its impact on neonatal immunization.
Keyphrases
- rheumatoid arthritis
- pregnancy outcomes
- preterm birth
- drug induced
- pregnant women
- healthcare
- weight gain
- atopic dermatitis
- preterm infants
- early onset
- electronic health record
- oxidative stress
- health insurance
- big data
- clinical trial
- health information
- single molecule
- social media
- machine learning
- artificial intelligence
- physical activity
- body mass index
- replacement therapy
- data analysis
- study protocol