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Observational Study
. 2024 Dec;56(12):2038-2044.
doi: 10.1016/j.dld.2024.06.011. Epub 2024 Jul 8.

Risk of anti-TNF therapy on pregnancy, breastfeeding, live vaccines and related information in patients with inflammatory bowel disease: Real-world data from a nationwide study

S Bendaoud  1 , S Nahon  2 , L Beaugerie  3 , J M Gornet  4 , P Wils  5 , A Amiot  6 , L Peyrin-Biroulet  7 , V Abitbol  8 , X Hébuterne  9 , R Altwegg  10 , I Rosa  11 , M Amil  12 , F Heluwaert  13 , L Plastaras  14 , C Stefanescu  15 , V Quentin  16 , M Antoni  17 , K Bideau  18 , M Boualit  19 , E Cuillerier  20 , C Locher  21 , F Skinazi  22 , A Boureille  23 , A Buisson  24 , M Simon  25
Affiliations
Observational Study

Risk of anti-TNF therapy on pregnancy, breastfeeding, live vaccines and related information in patients with inflammatory bowel disease: Real-world data from a nationwide study

S Bendaoud et al. Dig Liver Dis. 2024 Dec.

Abstract

Background: Anti-TNF are usually maintained during pregnancy in patients with inflammatory bowel disease (IBD) but safety is still a concern for them.

Aims: To provide data on management of anti-TNF agents during pregnancy, safety of live vaccines (BCG-MMR-rotavirus) and breastfeeding in newborns and dedicated information delivered to IBD women.

Methods: We performed an observational study in 25 centers from 2016 to 2018. We administered questionnaires to women with IBD receiving anti-TNF during pregnancy with newborn follow-up ≥ one year.

Results: Of 153 patients, 52 % maintained anti-TNF during the third trimester. Anti-TNF was shortly resumed in 79 % (58/73) after delivery. The rate of breastfeeding was 44 % (68/153) without any complication; 38 % of the mothers denied to breastfeed based on physician's advice. 26 % (34/129) of the newborns received live vaccines before 6 months-old (BCG:30 %; MMR:63 %; Rotavirus:8 %) and only 3 complications occurred (local BCGitis=1, fever=2). Information concerning anti-TNF during pregnancy/post-partum was delivered to 92 % of the patients, mainly by a gastroenterologist (97 %) who discussed with the obstetrician or the paediatrician in only 48 % and 25 %.

Conclusion: In IBD patients, maintaining anti-TNF during pregnancy and breastfeeding is safe. Accidental live vaccines before 6 months did not lead to significant adverse events. The communication about these questions remains to improve.

Keywords: Anti-TNF therapy; Breastfeeding; Inflammatory bowel disease; Live vaccines; Pregnancy.

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Conflict of interest statement

Declaration of competing interest Romain Altwegg received board or lectures fees from Abbvie, Janssen, Pfizer, Takeda. Vered Abitbol received lecture fees from Biogen Amgen Sandoz Mylan Pfizer Takeda Janssen, Gilead, Tillots. Laurent Peyrin-Biroulet received consulting fees from Merck, Abbvie, Janssen, Genentech. Ferring, Norgine, Tillots, Vifor, Shire, Therakos, Pharmacosmos, Pilège, BMS, UCB-Pharma. Hospira, Celltrion, Takeda, Biogaran, Boerhinger-Ingelheim, Lilly, Pfizer, and HAC-Pharma. This author also received lecture fees from Merck, Abbvie, Takeda, Janssen Cilag, Ferring. Norgine, Tillots, Vifor, Therakos, HAC-Pharma, and Mitsubishi. No conflicts of interest are claimed by the remaining authors.

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