Special aspects of biologics treatment in psoriasis: management in pregnancy, lactation, surgery, renal impairment, hepatitis and tuberculosis

Plachouri, Kerasia‐Maria; Georgiou, Sophia

doi:10.1080/09546634.2018.1544413

Cited by 11 publications

(12 citation statements)

References 61 publications

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“…However, the use of Fc‐containing biologics (including etanercept, adalimumab) during the third trimester is not recommended. We also advise that infliximab, secukinumab, ixekizumab, brodalumab and ustekinumab may be used in female patients wishing to conceive; however, data are limited with these biological drugs 12–14 …”

Section: Resultsmentioning

confidence: 99%

“…We also advise that infliximab, secukinumab, ixekizumab, brodalumab and ustekinumab may be used in female patients wishing to conceive; however, data are limited with these biological drugs. [12][13][14] Regarding the conventional drugs, cyclosporine should not be used during pregnancy unless the potential benefit to the mother justifies the potential risk to the foetus. 15 We also recommend that female psoriasis patients who may wish to conceive to have completed acitretin treatment at least 3 years before conception due to the high teratogenicity risk associated with this drug.…”

Section: Clinical Recommendationsmentioning

confidence: 99%

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Practical recommendations for systemic treatment in psoriasis according to age, pregnancy, metabolic syndrome, mental health, psoriasis subtype and treatment history (BETA‐PSO: Belgian Evidence‐based Treatment Advice in Psoriasis; part 1)

Lambert

Segaert²,

Ghislain

et al. 2020

Acad Dermatol Venereol

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Background Impressive progress in new therapeutic options has been made for psoriasis. Treatments include topical steroids, phototherapy, conventional, synthetic disease-modifying drugs and an expanding list of biologics. Objective The primary objective of this work was to collect evidence for the creation of practice guidelines for systemic treatment of psoriasis (BETA-PSO: Belgian Evidence-based Treatment Advice in Psoriasis). Methods Evidence-based recommendations were formulated using a quasi-Delphi methodology after a systematic search of the literature and a consensus procedure involving 8 psoriasis experts. Results In this part, the use of systemic treatment in different age groups, during pregnancy, in metabolic syndrome, in patients with mental health problems, in different psoriasis subtypes and in previously systemically treated patients treatment is discussed. Conclusion Guidance on therapeutic choice in specific clinical situations in psoriasis is provided in order to facilitate the decision-making in clinical practice.

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Section: Resultsmentioning

confidence: 99%

Section: Clinical Recommendationsmentioning

confidence: 99%

Practical recommendations for systemic treatment in psoriasis according to age, pregnancy, metabolic syndrome, mental health, psoriasis subtype and treatment history (BETA‐PSO: Belgian Evidence‐based Treatment Advice in Psoriasis; part 1)

Lambert

Segaert²,

Ghislain

et al. 2020

Acad Dermatol Venereol

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“…Most clinical trials which tested the drugs in question for psoriasis treatment excluded pregnant patients, mostly for ethical reasons. It is one of the reasons for the lack of adequate data regarding safety of these therapies in women planning pregnancy and those who are pregnant or during lactation [ 6 , 37 , 38 ]. The majority of data on safety comes from studies in animals as well as registries and retrospective studies.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment continuation should each time be discussed individually with the patients, taking all risks and benefits into account [ 38 ]. No conclusions can be drawn now on the safety of using ustekinumab and secukinumab prior to and during pregnancy due to the lack of relevant data [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

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The use of biological drugs in psoriasis patients prior to pregnancy, during pregnancy and lactation: a review of current clinical guidelines

Owczarek¹,

Walecka²,

Lesiak³

et al. 2020

pdia

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Introduction Information on the possibility of using biological drugs in psoriasis patients planning to conceive, patients who are pregnant or during lactation is limited. Aim Presenting recommendations published in clinical guidelines regarding the use of biological drugs – adalimumab, brodalumab, certolizumab pegol, etanercept, guselkumab, infliximab, ixekizumab, risankizumab, secukinumab, tildrakizumab, and ustekinumab, by psoriasis patients in the period of planning pregnancy, during pregnancy or during lactation. Material and methods The paper was based on a comprehensive review of over 40 websites of HTA agencies, dermatological associations worldwide and medical databases (PubMed, Embase), the objective of which was to identify clinical guidelines relating to biological treatment of women of childbearing potential, published after 2018, which used GRADE – a system for rating the quality of a body of evidence. Findings Certolizumab pegol is recommended in women who are planning to conceive. Furthermore, guidelines indicate other TNF-α inhibitors as possible treatment. Certolizumab pegol is also recommended as first-line treatment in pregnant patients. Furthermore, for trimesters 2 and 3, guidelines allow using other TNF-α inhibitors. Treatment with secukinumab and ustekinumab should be discontinued when planning pregnancy or when pregnancy was diagnosed. Biological treatment during pregnancy and lactation (continuation or initiation of treatment) can be used only after an analysis of risks and benefits has been conducted. Conclusions TNF-α inhibitors seem to be the safest and most researched biological drugs used in psoriasis treatment of patients planning to conceive, during pregnancy or lactation. Given its non-existent or minimal placental permeability, most likely the safest alternative is certolizumab pegol.

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Psoriasis Biologic Agents in Special Populations

Thatiparthi

Martin

Liu

et al. 2022

Updates in Clinical Dermatology

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Special aspects of biologics treatment in psoriasis: management in pregnancy, lactation, surgery, renal impairment, hepatitis and tuberculosis

Cited by 11 publications

References 61 publications

Practical recommendations for systemic treatment in psoriasis according to age, pregnancy, metabolic syndrome, mental health, psoriasis subtype and treatment history (BETA‐PSO: Belgian Evidence‐based Treatment Advice in Psoriasis; part 1)

Practical recommendations for systemic treatment in psoriasis according to age, pregnancy, metabolic syndrome, mental health, psoriasis subtype and treatment history (BETA‐PSO: Belgian Evidence‐based Treatment Advice in Psoriasis; part 1)

The use of biological drugs in psoriasis patients prior to pregnancy, during pregnancy and lactation: a review of current clinical guidelines

Psoriasis Biologic Agents in Special Populations

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