Management of the pregnant inflammatory bowel disease patient on antitumour necrosis factor therapy: state of the art and future directions

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Management of the pregnant inflammatory bowel disease patient on antitumour necrosis factor therapy : state of the art and future directions. / Leung, Yvette; Panaccione, Remo; Ghosh, Subrata; Seow, Cynthia H.

In: Canadian Journal of Gastroenterology and Hepatology, Vol. 28, No. 9, 01.10.2014, p. 505-9.

Research output: Contribution to journalReview articlepeer-review

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@article{bdf6ee92273648139b6aea2cc2d800e4,
title = "Management of the pregnant inflammatory bowel disease patient on antitumour necrosis factor therapy: state of the art and future directions",
abstract = "Antitumour necrosis factor (anti-TNF) therapy has been a major advance in the treatment of inflammatory bowel disease (IBD) by improving rates of mucosal healing, steroid-free remission, and decreasing rates of hospitalization and surgery. Because IBD affects women in their reproductive years, clinicians have and will continue to be asked in the future about the safety profile of these agents and their potential impact on pregnancy, the developing fetus and newborn. Immunoglobulin G transfer from the mother to fetus begins in the second trimester, with an elevation starting at 22 weeks of gestation and the largest amount transferred in the third trimester. Although research investigating the long-term outcomes of children exposed to anti-TNF therapy in utero is limited, there is no known adverse effect on either pregnancy or newborn outcomes including infectious complications with this class of drugs. The World Congress of Gastroenterology consensus statement on biological therapy for IBD considered infliximab and adalimumab to be low risk and compatible with use during conception and during pregnancy in at least the first two trimesters. Based on a clinical algorithm used at the University of Calgary Pregnancy and IBD clinic (Calgary, Alberta), recommendations have been provided on the management of pregnant patients on anti-TNF therapy, particularly with regard to third-trimester dosing, taking into account disease characteristics of individual patients. When educated about the safety of anti-TNF therapy during pregnancy, patients often choose to continue on therapy during the third trimester.",
keywords = "Adalimumab, Antibodies, Monoclonal, Antibodies, Monoclonal, Humanized, Canada, Congresses as Topic, Evidence-Based Medicine, Female, Gastrointestinal Agents, Humans, Inflammatory Bowel Diseases, Infliximab, Practice Guidelines as Topic, Pregnancy, Pregnancy Complications, Treatment Outcome, Tumor Necrosis Factor-alpha, Journal Article, Review, Antitumour necrosis factor therapy, Inflammatory bowel disease",
author = "Yvette Leung and Remo Panaccione and Subrata Ghosh and Seow, {Cynthia H}",
year = "2014",
month = oct,
day = "1",
doi = "10.1155/2014/967598",
language = "English",
volume = "28",
pages = "505--9",
journal = "Canadian Journal of Gastroenterology and Hepatology",
issn = "2291-2789",
publisher = "Pulsus Group Inc.",
number = "9",

}

RIS

TY - JOUR

T1 - Management of the pregnant inflammatory bowel disease patient on antitumour necrosis factor therapy

T2 - state of the art and future directions

AU - Leung, Yvette

AU - Panaccione, Remo

AU - Ghosh, Subrata

AU - Seow, Cynthia H

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Antitumour necrosis factor (anti-TNF) therapy has been a major advance in the treatment of inflammatory bowel disease (IBD) by improving rates of mucosal healing, steroid-free remission, and decreasing rates of hospitalization and surgery. Because IBD affects women in their reproductive years, clinicians have and will continue to be asked in the future about the safety profile of these agents and their potential impact on pregnancy, the developing fetus and newborn. Immunoglobulin G transfer from the mother to fetus begins in the second trimester, with an elevation starting at 22 weeks of gestation and the largest amount transferred in the third trimester. Although research investigating the long-term outcomes of children exposed to anti-TNF therapy in utero is limited, there is no known adverse effect on either pregnancy or newborn outcomes including infectious complications with this class of drugs. The World Congress of Gastroenterology consensus statement on biological therapy for IBD considered infliximab and adalimumab to be low risk and compatible with use during conception and during pregnancy in at least the first two trimesters. Based on a clinical algorithm used at the University of Calgary Pregnancy and IBD clinic (Calgary, Alberta), recommendations have been provided on the management of pregnant patients on anti-TNF therapy, particularly with regard to third-trimester dosing, taking into account disease characteristics of individual patients. When educated about the safety of anti-TNF therapy during pregnancy, patients often choose to continue on therapy during the third trimester.

AB - Antitumour necrosis factor (anti-TNF) therapy has been a major advance in the treatment of inflammatory bowel disease (IBD) by improving rates of mucosal healing, steroid-free remission, and decreasing rates of hospitalization and surgery. Because IBD affects women in their reproductive years, clinicians have and will continue to be asked in the future about the safety profile of these agents and their potential impact on pregnancy, the developing fetus and newborn. Immunoglobulin G transfer from the mother to fetus begins in the second trimester, with an elevation starting at 22 weeks of gestation and the largest amount transferred in the third trimester. Although research investigating the long-term outcomes of children exposed to anti-TNF therapy in utero is limited, there is no known adverse effect on either pregnancy or newborn outcomes including infectious complications with this class of drugs. The World Congress of Gastroenterology consensus statement on biological therapy for IBD considered infliximab and adalimumab to be low risk and compatible with use during conception and during pregnancy in at least the first two trimesters. Based on a clinical algorithm used at the University of Calgary Pregnancy and IBD clinic (Calgary, Alberta), recommendations have been provided on the management of pregnant patients on anti-TNF therapy, particularly with regard to third-trimester dosing, taking into account disease characteristics of individual patients. When educated about the safety of anti-TNF therapy during pregnancy, patients often choose to continue on therapy during the third trimester.

KW - Adalimumab

KW - Antibodies, Monoclonal

KW - Antibodies, Monoclonal, Humanized

KW - Canada

KW - Congresses as Topic

KW - Evidence-Based Medicine

KW - Female

KW - Gastrointestinal Agents

KW - Humans

KW - Inflammatory Bowel Diseases

KW - Infliximab

KW - Practice Guidelines as Topic

KW - Pregnancy

KW - Pregnancy Complications

KW - Treatment Outcome

KW - Tumor Necrosis Factor-alpha

KW - Journal Article

KW - Review

KW - Antitumour necrosis factor therapy

KW - Inflammatory bowel disease

U2 - 10.1155/2014/967598

DO - 10.1155/2014/967598

M3 - Review article

C2 - 25101334

VL - 28

SP - 505

EP - 509

JO - Canadian Journal of Gastroenterology and Hepatology

JF - Canadian Journal of Gastroenterology and Hepatology

SN - 2291-2789

IS - 9

ER -