Update on biologic safety for patients with psoriasis during pregnancy

Abstract

Biologic agents have become more common to treat patients with psoriasis, but concerns about their effect on pregnancy and lactation often preclude this treatment during these time periods. During the past decade, we have gained a much better understanding of the course of psoriasis during pregnancy and the safety of the use of biologic agents during pregnancy and lactation. Under certain circumstances, biologic agents can be considered appropriate treatment options for patients who are pregnant or lactating.

Crossed looks on the dermatologist's position and the patient's preoccupations as to psoriasis and pregnancy: preliminary results of the PREGNAN‐PSO study

“…Therefore, appropriate disease control prior and during pregnancy should likely optimize maternal and foetal health. 6 Considering these critical issues, it is surprising to note that, based on our survey data, only slightly more than one-quarter of D are aware of the existence of recommendations relating to the management of patients of childbearing potential suffering from psoriasis, with only a minority considering these recommendations appropriate. Of note is that this lack of knowledge and disaffection was even stronger among the D pertaining to the biological agent generation than among their senior colleagues.…”

“…Over the past decade, biological agents have emerged as a cornerstone of psoriasis management. 6 As of today, while newer and more effective targeted therapies are incessantly made available, there is a serious gap in our understanding of these drugs' safety in women with psoriasis, as well as of the long-term outcomes in children exposed in utero to these agents. Accordingly, D who somewhat understand both the clinical course of psoriasis and impact of therapeutic agents during pregnancy should be better equipped to appropriately weigh the risks and benefits of treatments and counsel the patients appropriately.…”

Secukinumab in pregnancy: outcomes in psoriasis, psoriatic arthritis and ankylosing spondylitis from the global safety database

“…Effective long‐term treatment may be necessary in women of childbearing age, but data concerning current treatments and pregnancy remain incomplete. Due to immunological changes, psoriasis and, to a lesser extent, PsA generally improve during pregnancy; however, many pregnant patients still require treatment. AS tends to have an adverse effect on health‐related quality of life during pregnancy …”

“…3 There is growing evidence to suggest that biological treatments for inflammatory conditions are not detrimental during pregnancy. 1 Secukinumab is a fully human monoclonal antibody that selectively targets ilnterleukin-17A, and shows sustained efficacy in the treatment of moderate-to-severe psoriasis, PsA and AS, with a favourable safety profile. 4,5 As an IgG1 molecule, secukinumab could theoretically cross the placenta, but most antibody transfer occurs in the third trimester.…”

“…This cohort of pregnant patients taking secukinumab for psoriasis, PsA and AS adds to existing evidence for the safety of biologics in pregnancy. 1 No safety signals were identified regarding spontaneous abortions or congenital malformations. In clinical practice, these data provide reassurance in cases where conception occurs during secukinumab treatment.…”