Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Therapy

Are TNF inhibitors safe in pregnancy?

Tumor necrosis factor inhibitors are fast acting, highly effective and well tolerated by the majority of patients, but their safety in pregnant women remains a matter of debate. The latest research weighs in on the issue.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Hyrich, K., Symmons, D., Watson, K. & Silman, A. Pregnancy outcome in women who were exposed to anti-TNF agents: results from a national population register. Arthritis Rheum. 54, 2701–2702 (2006).

    Article  Google Scholar 

  2. Berthelot, J. M. et al. Exposition to anti-TNF drugs during pregnancy: outcome of 15 cases and review of the literature. Joint Bone Spine 76, 28–34 (2009).

    Article  CAS  Google Scholar 

  3. Carter, J. D. et al. A safety assessment of tumor necrosis factor antagonists during pregnancy: a review of the FDA database. J. Rheumatol. doi:10.3899/jrheum.080545 (2008).

  4. Carter, J., Valeriano, J. & Vasey, F. B. Tumor necrosis factor-alpha inhibition and VATER association: a causal relationship? J. Rheumatol. 33, 1014–1017 (2006).

    Google Scholar 

  5. Källén, K., Mastroiacovo, P., Castilla, E. E., Robert, E. & Källén, B. VATER non-random association of congenital malformations: study based on data from four malformation registers. Am. J. Med. Gen. 101, 26–32 (2001).

    Article  Google Scholar 

  6. Katz, J. A. et al. Outcome of pregnancy in women receiving infliximab for the treatment of Crohn's disease and rheumatoid arthritis. Am. J. Gastroenterol. 99, 2385–2392 (2004).

    Article  Google Scholar 

  7. Winger, E. E. & Reed, J. L. Treatment with tumor necrosis factor inhibitors and intravenous immunoglobulin improves live birth rates in women with recurrent spontaneous abortion. Am. J. Reprod. Immunol. 60, 8–16 (2008).

    Article  CAS  Google Scholar 

  8. Chambers, C. D., Tutuncu, Z. N., Johnson, D. & Jones, K. L. Human pregnancy safety for agents used to treat rheumatoid arthritis: adequacy of available information and strategies for developing post-marketing data. Arthritis Res. Ther. 8, 215 (2006).

    Article  Google Scholar 

  9. Johnson, D. L., Jones, K. L. & Chambers, C. D. Pregnancy outcome in women exposed to adalimumab: the OTIS autoimmune diseases in pregnancy project. Ann. Rheum. Dis. 66 (Suppl. 2), 174 (2007).

    Google Scholar 

  10. Østensen, M. et al. Pregnancy in patients with rheumatic disease: anti-inflammatory cytokines increase in pregnancy and decrease post partum. Ann. Rheum. Dis. 64, 839–844 (2005).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Ethics declarations

Competing interests

The author has declared that she has received speaker's bureau honoraria from Essex, Abbott and Wyeth.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Østensen, M. Are TNF inhibitors safe in pregnancy?. Nat Rev Rheumatol 5, 184–185 (2009). https://doi.org/10.1038/nrrheum.2009.47

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrrheum.2009.47

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing