Abstract:After several decades of deliberation, the US Food and Drug Administration updated the Pregnancy and Lactation Labeling Rule in 2015, eliminating the prior A, B, C, D, X grading system for medication use in pregnancy. Although physicians and patients liked the relative ease of use of this system, it was often misconstrued and not updated to include new data suggesting greater compatibility of medications with pregnancy. The new label is designed to include more clinically relevant data, including data from hum… Show more
“…This reflects unplanned pregnancies and pregnancies in those women for whom the benefits of using the biologic to control disease activity, particularly in the first and/or second trimester, is deemed to outweigh theoretical risks. New FDA rules in place since 2015 mean that applications for drug approvals must provide pregnancy and lactation information for the label, including the details of any existing pregnancy registry [59]. A pregnancy registry would be a most useful contribution to the post-approval process for anifrolumab given the lack of pre-existing human or animal data for medications of this class.…”
Introduction: The type 1 interferon pathway is known to play a role in the immunopathology of Systemic Lupus Erythematosus (SLE). As a result, biologic agents targeting this pathway have been developed and are currently being investigated in clinical trials. Areas covered: We review the biologic agents which have been developed to antagonise type I interferons in SLE. We focus on anifrolumab, a type I interferon receptor antagonist, and consider the complexities of defining efficacy in SLE clinical trials. Expert opinion: Anifrolumab shows promise as an addition to the SLE therapeutic armamentarium. Despite discordant results between its two phase III studies, there is a convincing suggestion of benefit in both trials to encourage the view that this approach might be effective. Data acquired thus far look particularly useful for cutaneous disease. We await data on its effect on renal, pulmonary, cardiac and central nervous system involvement, on patient reported outcomes, and its safety and efficacy with long term use.
“…This reflects unplanned pregnancies and pregnancies in those women for whom the benefits of using the biologic to control disease activity, particularly in the first and/or second trimester, is deemed to outweigh theoretical risks. New FDA rules in place since 2015 mean that applications for drug approvals must provide pregnancy and lactation information for the label, including the details of any existing pregnancy registry [59]. A pregnancy registry would be a most useful contribution to the post-approval process for anifrolumab given the lack of pre-existing human or animal data for medications of this class.…”
Introduction: The type 1 interferon pathway is known to play a role in the immunopathology of Systemic Lupus Erythematosus (SLE). As a result, biologic agents targeting this pathway have been developed and are currently being investigated in clinical trials. Areas covered: We review the biologic agents which have been developed to antagonise type I interferons in SLE. We focus on anifrolumab, a type I interferon receptor antagonist, and consider the complexities of defining efficacy in SLE clinical trials. Expert opinion: Anifrolumab shows promise as an addition to the SLE therapeutic armamentarium. Despite discordant results between its two phase III studies, there is a convincing suggestion of benefit in both trials to encourage the view that this approach might be effective. Data acquired thus far look particularly useful for cutaneous disease. We await data on its effect on renal, pulmonary, cardiac and central nervous system involvement, on patient reported outcomes, and its safety and efficacy with long term use.
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