Biologicals in atopic disease in pregnancy: An EAACI position paper

Autor: Adam Chaker, Zsolt Szépfalusi, Juan José Yepes-Nuñez, Onur Boyman, A. Vultaggio, Alexia Chatzipetrou, Oscar Palomares, Cezmi A. Akdis, Marek Jutel, Eva Untersmayr, Andrea Matucci, Mohammad Alsalamah, Alanna Marson, Sevim Bavbek, Paula Kauppi, Birgit Pfaller, Barbara Rogala, Antonios G.A. Kolios, Sarah Bendien, Susan Chan, Ioana Agache, Thomas Eiwegger, Carmen Li, Apostolos Bossios, George Du Toit
Přispěvatelé: HUS Inflammation Center, Department of Dermatology, Allergology and Venereology, Helsinki University Hospital Area, University of Helsinki, University of Zurich, Eiwegger, Thomas
Rok vydání: 2021
Předmět:
0301 basic medicine
Allergy
Omalizumab
GUIDELINES
Inflammatory bowel disease
Biological Factors
0302 clinical medicine
10183 Swiss Institute of Allergy and Asthma Research
Multicenter Studies as Topic
Immunology and Allergy
atopic dermatitis
10177 Dermatology Clinic
Atopic dermatitis
CROHNS-DISEASE
3. Good health
biologicals
2723 Immunology and Allergy
Female
Rituximab
pregnancy
medicine.drug
medicine.medical_specialty
1ST TRIMESTER
Immunology
610 Medicine & health
OMALIZUMAB USE
Dermatitis
Atopic
03 medical and health sciences
MANAGEMENT
medicine
Humans
RITUXIMAB
REGULATORY T-CELLS
Intensive care medicine
Asthma
Biological Products
2403 Immunology
Pregnancy
business.industry
Infant
Newborn
asthma
medicine.disease
body regions
030104 developmental biology
030228 respiratory system
3121 General medicine
internal medicine and other clinical medicine
10033 Clinic for Immunology
MODIFYING ANTIRHEUMATIC DRUGS
Position paper
business
INFLAMMATORY-BOWEL-DISEASE
Zdroj: Allergy. 76:71-89
ISSN: 1398-9995
0105-4538
Popis: Biologicals have transformed the management of severe disease phenotypes in asthma, atopic dermatitis, and chronic spontaneous urticaria. As a result, the number of approved biologicals for the treatment of atopic diseases is continuously increasing. Although atopic diseases are among the most common diseases in the reproductive age, investigations, and information on half-life, pharmacokinetics defining the neonatal Fc receptors (FcRn) and most important safety of biologicals in pregnancy are lacking. Given the complex sequence of immunological events that regulate conception, fetal development, and the intrauterine and postnatal maturation of the immune system, this information is of utmost importance. We conducted a systematic review on biologicals in pregnancy for indications of atopic diseases. Evidence in this field is scare and mainly reserved to reports on the usage of omalizumab. This lack of evidence demands the establishment of a multidisciplinary approach for the management of pregnant women who receive biologicals and multicenter registries for long-term follow-up, drug trial designs suitable for women in the reproductive age, and better experimental models that represent the human situation. Due to the very long half-life of biologicals, pre-conception counseling, and health care provider education is crucial to offer the best care for mother and fetus. This position paper integrates available data on safety of biologicals during pregnancy in atopic diseases via a systematic review with a detailed review on immunological considerations how inhibition of different pathways may impact pregnancy.
Databáze: OpenAIRE
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