From mother to baby: antenatal exposure to monoclonal antibody biologics
| Autor: | Wendy Vaudry, Vivian Huang, Geoffrey C. Nguyen, Karina A. Top, Anne Pham-Huy, Monika Ostensen, Manish Sadarangani, Sarah M Troster, Eliana Castillo |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
medicine.drug_class Immunology Monoclonal antibody Autoimmune Diseases 03 medical and health sciences 0302 clinical medicine Pregnancy Ustekinumab Adalimumab Immunology and Allergy Medicine Humans 030203 arthritis & rheumatology Biological Products business.industry Infant Newborn Infant exposure Antibodies Monoclonal medicine.disease Infliximab Pregnancy Complications 030104 developmental biology Prenatal Exposure Delayed Effects Female business Immunosuppressive Agents medicine.drug |
| Zdroj: | Expert review of clinical immunology. 15(3) |
| ISSN: | 1744-8409 |
| Popis: | More women with autoimmune and inflammatory conditions are being treated with monoclonal antibody biologics (mAbs) during their pregnancy, to maintain clinical remission. The use of anti-tumor necrosis factor alpha agents in pregnancy appears to be safe but less is known regarding other mAbs, such as anti-integrins and anti-cytokine agents. There are currently no comprehensive guidelines on how to manage the exposed infants. Areas covered: We review recent literature to assess the impact of mAbs on birth and early infant outcomes, including what is currently known about maternal and infant drug levels at birth and drug clearance in the infant. We describe the potential risks of infections and reported hematological and immunological effects of antenatal mAbs exposure on the infant and provide guidance on the management of the exposed infant. Expert opinion: Exposed infants should be monitored closely. Certain mAb exposures require specific testing and management. Safety monitoring should be done in a multidisciplinary approach and should include pediatric care providers. The current clinical experience with anti-tumor necrosis factor agents in pregnancy cannot be extrapolated to other mAbs. Long-term observational studies and a multicenter international registry are needed to better appreciate the impact of exposure, especially to newer mAbs. |
| Databáze: | OpenAIRE |
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