In a nutshell
This study looked at the effects of maternal and paternal exposure to the drug abatacept (Orencia). Based on the data, there were no increased instances of birth abnormalities.
Some background
Rheumatoid arthritis (RA) is a chronic autoimmune disease which causes inflammation of the joints. Medications used to treat chronic conditions like RA must be carefully managed during pregnancy. The mother may suffer inflammation from RA during pregnancy and may need medication. Some drugs, however, can cross to the fetus, depending on the treatment and the number of weeks pregnant.
There is little information on the effects of RA medications during pregnancy. Some drugs used to treat RA are called disease-modifying, antirheumatic drugs (DMARDs). Non-biological DMARDs (such as methotrexate) are known to cause fetal death and birth defects, and must be stopped before planning a pregnancy. There is currently no evidence that biological DMARDs (treatments that target certain proteins) affect the fetus. Abatacept is a biological DMARD used to treat moderate to severe RA. There is limited data on pregnancy outcomes in patients using abatacept.
Methods & findings
This study presents known pregnancy outcomes from both maternal (mother) and paternal (father) exposure to abatacept during conception and pregnancy. Patient data was obtained from a database that collects patient information from clinical trials.
A total of 161 pregnancies were included (151 from maternal exposure and 10 from paternal exposure to abatacept). Following maternal exposure, 26.5% of the pregnancies resulted in miscarriage and 12.6% resulted in elective abortion. Fetal abnormalities were reported in 8.1%. There was no pattern to the type of abnormalities seen.
There were no abnormalities or miscarriages following paternal exposure to abatacept.
The bottom line
This study concluded that there were no specific trends in fetal abnormalities following exposure to abatacept during pregnancy. The authors note, however, that abatacept should still be used during pregnancy only if the potential benefit to the mother justifies the potential risk to the fetus.
The fine print
This study was carried out by the manufacturer of abatacept. Some data was incomplete. The severity of RA in patients was unknown. These patients may have also had other unknown illnesses.
What’s next?
Discuss your treatment options during pregnancy with your doctor, preferably before you begin trying to conceive.
Published By :
Seminars in Arthritis and Rheumatism
Date :
Dec 01, 2015
