ArticleAnnals of the rheumatic diseases2022
Analysing cord blood levels of TNF inhibitors to validate the EULAR points to consider for TNF inhibitor use during pregnancy.
Article in Annals of the rheumatic diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 28 citations in OpenAlex.
- Fertility and Birth Outcomes in Rheumatoid Arthritis: A Narrative Review.Rheumatology and therapy · 2026Review
- What to do when the first TNF inhibitor fails in rheumatoid arthritis: stratified expert recommendations from a scoping review and Delphi consensus.Therapeutic advances in musculoskeletal disease · 2026Article
- Hidradenitis Suppurativa Treatment During Pregnancy and Lactation: Navigating Challenges.International journal of dermatology · 2025Review
- Family Planning and Rheumatoid Arthritis.Current rheumatology reports · 2025Review
- Association Between Maternal IBD-Related Antibodies and Early Life Gut Inflammatory Status and Microbiota Composition: Insights from Cord Blood.Journal of inflammation research · 2025Article
- Rheumatoid Arthritis and Pregnancy: Managing Disease Activity and Fertility Concerns.Seminars in reproductive medicine · 2024Review
- Management of Rheumatic Diseases During Pregnancy and Breastfeeding: Position Paper of the Working Group for Obstetrics and Prenatal Medicine in the German Society for Gynecology and Obstetrics e. V. (AGG - Section Maternal Diseases in Pregnancy).Geburtshilfe und Frauenheilkunde · 2024Article
- Physiologic Changes During Pregnancy and Impact on Small-Molecule Drugs, Biologic (Monoclonal Antibody) Disposition, and Response.Journal of clinical pharmacology · 2023Review
- Reported congenital malformations after exposure to non-tumour necrosis factor inhibitor biologics: A retrospective comparative study in EudraVigilance.British journal of clinical pharmacology · 2022Article
- Pharmacovigilance pregnancy data in a large population of patients with chronic inflammatory disease exposed to certolizumab pegol.Therapeutic advances in musculoskeletal disease · 2022Article
- Continuous Use of Etanercept During Pregnancy Does Not Affect TNF-Alpha Levels in Umbilical Cord Blood.Biologics : targets & therapy · 2022Article
- [Current aspects of antirheumatic therapy in pregnancy planning, during pregnancy and breastfeeding].Zeitschrift fur Rheumatologie · 2021Review
- Maternal and Fetal-Placental Effects of Etanercept Treatment During Rats' Pregnancy.Frontiers in physiology · 2021Article
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo minimise placental transfer of tumour necrosis factor inhibitors (TNFi), the European League Against Rheumatism (EULAR) created points to consider (PtC) for the use of TNFi during pregnancy. We are the first to validate the EULAR-PtC by analysing TNFi concentrations in cord blood.
methodsPatients were derived from the Preconceptional Counselling in Active Rheumatoid Arthritis Study. TNFi was stopped at the time points recommended by the EULAR. Maternal blood and cord blood were collected and analysed for the concentration of TNFi.
results111 patients were eligible for the analysis. Median stop time points were gestational age (GA) 37.0 weeks for certolizumab pegol, GA 25.0 weeks for etanercept, GA 19.0 weeks for adalimumab and GA 18.4 weeks for infliximab. Certolizumab pegol (n=68) was detectable in 5.9% of cord blood samples, with a median concentration of 0.3 µg/mL (IQR: 0.2-1.3) and a median cord/maternal concentration ratio of 0.010. Etanercept (n=30) was not detected in any cord blood samples. Adalimumab (n=25) was detectable in 48.0% of cord blood samples, with a median concentration of 0.5 µg/mL (IQR: 0.2-0.7) and a median concentration ratio of 0.062 (IQR: 0.018-0.15). Infliximab (n=14) was detectable in 57.1% of cord blood samples, with a median concentration of 0.4 µg/mL (IQR: 0.1-1.2) and a median concentration ratio of 0.012 (IQR: 0.006-0.081).
conclusionCompliance with the EULAR-PtC results in absence or low levels of TNFi in cord blood.
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