Breastfeeding in patients with Gaucher disease: Is taliglucerase alfa safe?

Paskulin, Livia; Dornelles, Alícia Dorneles; Quevedo, Alexandre Silva de; Nalin, Tatiéle; Tirelli, Kristiane Michellin; Vairo, Filippo Pinto e; Schwartz, Ida Vanessa Döederlein

doi:10.1016/j.ymgmr.2018.11.004

Cited by 1 publication

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“…An expert group opinion approving ERT with imiglucerase for symptomatic pregnant GD1 patients was first published in 2011 5 . Later reports described a small series of GD patients receiving other ERT preparations during pregnancy, with good outcomes for most treated patients 11‐13 . Preparatory measures for women with GD contemplating pregnancy are not yet accepted as an indication for ERT.…”

Section: Introductionmentioning

confidence: 99%

Risk of postpartum hemorrhage in multiparous women with Gaucher disease: A call for reconsidering enzyme replacement therapy in all pregnant patients

Cohen

Frydman

Rotem

et al. 2021

J of Inher Metab Disea

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For the last three decades, enzyme replacement therapy (ERT) for Gaucher disease (GD) has been available. We aimed to evaluate the effect of ERT on the pregnancy and obstetric outcome in a unique group of multiparous women with type 1 GD (GD1) who had pregnancies with and without ERT. The Gaucher Unit database (1987‐2019) was searched for multiparous women who had pregnancies before and after the institution of ERT. Data were collected from the clinic files and study‐specific questionnaires. Descriptive, correlation analysis and generalized estimating equations (GEE) were used to study the effect of ERT and confounding variables on study outcomes. We identified 19 women with 105 pregnancies, among which 26 (24.7%) terminated in first‐trimester miscarriage. The risk for miscarriage was associated with the severity of GD1 genotype and phenotype, but not with ERT usage. Early postpartum hemorrhage (PPH) was reported in 16 (84%) women after 25 deliveries (31.6%, 95% CI 21.6%‐43.1%). The risks of early PPH and red blood cell (RBC) transfusions were significantly lower when ERT was used during pregnancy, OR (95% CI) 0.13 (0.03‐0.54) and 0.27 (0.08‐0.94), respectively, compared to pregnancies without the use of ERT. Enzyme replacement therapy during pregnancy is risk reducing for early PPH and RBC transfusions in women with GD1. We suggest considering ERT for the benefit of all pregnant women with GD1, including mild GD1.

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Section: Introductionmentioning

confidence: 99%