Anti-TNF Drugs During Pregnancy

Hi Dr. Borigini - thanks for this information.  Just wanted to comment that I used Enbrel during my first trimester of pregnancy following infertility treatment.  I had a previous pregnancy during which I discontinued usage after discovering I was pregnant, then miscarried just before my second trimester.  I continued the Enbrel for 16 weeks to try to avoid another miscarriage.  My rheumatologist strongly believes that I was failing to get successfully pregnant at least in part because of my RA (I'd become easily pregnant before my diagnosis) and therefore recommended continuing the Enbrel through the first trimester. 

 

I also took prednisone, 800 mgs of folic acid and progesterone in oil.  This was a combination of things I'd read about in the past that seemed to aid in continuing pregnancies.  During my third trimester I heard that a study in Europe showed a doubled success rate for women with previous miscarriges using these four drugs during their pregnancies.  Are you familiar with this study?  I believe I might owe my lovely, healthy twin daughters (now 8 months old) to this combination of drugs during my first trimester.

 

Thanks again for discussing this topic.

I was diagnosed with RA in my second trimester.  When I first saw a Rheumatologist he decided to keep me on the Ibuprofen dosage my OB ok'd since it seemed to work.  I am now up to taking 600-800mg 3x a day of Ibuprofen and am still suffering.  My RA doctor gave me a cortisone shot today which is apparently suppose to relieve my swollen knee and he said hopefully other parts that hurt too.  He has mentioned prednisone (sp?) but I'm scared of gaining more weight than needed for the pregnancy for fear that it will just make things worse for me (i.e. The heavier I get, the harder it is to walk).  Could this be true or am I just worrying for nothing?  He did mention it would be a very low dose.

I am a male who is taking both Humira and MTX. Previously, before I was prescribed humira I came off the MTX for 9 months before trying for a baby. My wife and I now have a little girl. We are thinking of having a second and obviously I would have to come off the MTX again. In your opinion, should I come off the humira also? I am a little fearful, as the psoriatic arthritis I have has responded really well to the humira.

 

Thanks,

 

Ray

I would like to thank Dr. Borigini for writing about Anti-TNF drugs during pregnancy. I work for the Organization of Teratology Information Specialists (OTIS). As Dr. Borigini had mentioned, OTIS is currently conducting an ongoing observational study on autoimmune diseases and pregnancy.

 

The OTIS Autoimmune Diseases in Pregnancy Study began in March 2000 and will continue through 2012. The purpose of the study is to evaluate the risks to the fetus from autoimmune diseases, as well as the safety of medications used to treat these diseases during pregnancy. Pregnant women who have been diagnosed with an autoimmune disease, or who may have been exposed to an Anti-TNF drug during pregnancy may be eligible to participate.

 

OTIS is a non-profit organization made up of individual teratology information services located throughout North America. Teratology Information Specialists (TIS) provide information over the telephone about possible risks to the fetus from environmental exposures that occur in pregnancy. Health-care professionals and the general public may use this free and confidential service by calling our toll-free number.

 

For information about the OTIS Autoimmune Diseases and Pregnancy Study or if you have questions about exposures during pregnancy, please call our toll free number 1-877-311-8972 or you can email raandpregnancy@ucsd.edu. To learn more about OTIS, please visit us online at www.otispregnancy.org.