Biologic Treatments for Autoimmune Diseases Do Not Affect Births, Study Finds

Ashraf Malhas, PhD avatar

by Ashraf Malhas, PhD |

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Biologics and births

Biologic treatments for lupus and other autoimmune diseases are safe for women who are pregnant, and do not have a significant effect on births, a study finds.

The study, published in Annals of the Rheumatic Diseases, is titled “Risk of preterm delivery and small-for-gestational-age births in women with autoimmune disease using biologics before or during pregnancy: a population-based cohort study.

A hallmark of autoimmune diseases is chronic inflammation that can cause problems during pregnancy. A molecule called tumor necrosis factor (TNF)-alpha regulates abnormal immune responses in autoimmune diseases such as rheumatoid arthritis and ankylosing spondylitis.

TNF-alpha is also involved in the labor process in pregnancy. High levels of it can lead to complications such as preterm delivery.

In the past 15 years, medications known as biologics have been used to treat autoimmune diseases by targeting inflammatory cytokines like TNF-alpha.

But no conclusive studies have been done on whether biologics can lead to premature deliveries or newborns that are too small. University of British Columbia researchers decided to remedy that.

They looked at the medical records of women in the Canadian province who had an autoimmune disease and became pregnant. Most had rheumatoid arthritis and inflammatory bowel disease. The study covered 6,218 women with 8,607 pregnancies.

Among them, 109 women with 120 pregnancies were being treated with biologics three months before or during pregnancy, while 584 women with 600 pregnancies had not been exposed to biologics.

TNF-alpha inhibitors, including Remicade (infliximab), Enbrel (etanercept) and Humira (adalimumab), accounted for 94% of the biologics that the 109 treated women used.

There was no significant difference in preterm births between women exposed to biologics and those who had not been exposed — 18% vs. 16%. The same applied to the birth of smaller than normal babies, with 9% of the exposed group having small newborns, compared with 10% in the unexposed group.

“Altogether, we found no association between biologics use before or during pregnancy and preterm delivery or SGA [smaller than normal] births in women with autoimmune diseases, compared with those who had comparable propensity to receive biologics during that time but did not,” the researchers wrote.

“Our findings suggest that biologics may be a safe treatment option for women with certain autoimmune diseases who, as previous research suggests, are at higher risk of adverse pregnancy outcomes due to their disease,” they wrote.