Infant serious infection reassurance for biologic use during pregnancy
medwireNews: The use of biologic agents by women with rheumatoid arthritis (RA) during pregnancy is not associated with a raised risk for serious or opportunistic infections for their infants, suggests research reported at the 2017 ACR/ARHP Annual Meeting in San Diego, California, USA.
“[T]hese results should be reassuring for women with RA who need to be treated throughout pregnancy with a biologic,” the presenting author told the press.
The analysis included data for 1123 US or Canadian pregnant women enrolled in the MotherToBaby study, of whom 490 had received biologic therapy for RA, while 221 were biologic-naïve and 412 were healthy controls free of any chronic conditions.
In the year following birth, 4.0% of 502 infants born to women exposed to biologics experienced a serious or opportunistic infection, defined as any infection requiring hospitalization or any of 15 predefined infections, including X-ray proven pneumonia, meningitis, bacteremia, and septic arthritis.
This incidence was comparable to the rates observed among babies of women with RA not treated with biologics and healthy controls, at 2.6% of 231 and 2.1% of 423, respectively.
Christina Chambers (University of California San Diego, La Jolla, USA) explained that there is a hypothetical concern that the risk for infection may be greater if biologic use occurs during the later gestational period when placental transfer may be increased.
But when the team considered only the infants of women who had continued to receive biologics during the third trimester, the rate of serious infections was 3.5%, which again did not differ significantly from the rates seen in the other study groups.
Chambers cautioned, however, that the study did not address the risks for milder infections, such as common cold, and also “cannot rule out low risks for serious infections.”
Speaking to medwireNews, she said that going forward they are planning studies with a longer follow-up of 5 years as well as assessing infants’ reactions to vaccines and neurodevelopment.
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