Certolizumab doesn’t cross the placenta

Rheumatoid arthritis

27 Jun 2017

The continuation of the anti-TNF certolizumab during pregnancy may be an option for women who need their disease activity controlled because it doesn’t cross the placenta in significant concentrations, a pharmacokinetic study shows.

Presenting their findings at EULAR the authors led by Professor Xavier Mariette from the University Hospitals of Paris-Sud, France, said they expected their findings to have a significant impact on clinical practice as women have generally stopped treatment because most anti-TNFs do cross the placenta.

“The results of this study support the continuation of certolizumab treatment during pregnancy when considered necessary to control disease activity,” they concluded.

However, they cautioned that patients would still be at an increased risk of adverse effects associated with anti-TNFs such as infection or immune reactions, which could have an adverse impact on pregnancy outcomes.

The CRIB study involved the samples of 13 infants who had no quantifiable CZP levels at birth (<0.032 μg/mL); 1 infant had a minimal CZP level of 0.042 μg/mL (infant/mother plasma ratio: 0.09%). No infants had quantifiable levels at weeks 4 and 8 of the study and no anti-CZP antibodies were detected in mothers, umbilical cords, or infants.

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