ArticleACR open rheumatology2026
Tumor Necrosis Factor Inhibitor Treatment and Persistence Patterns in the Peripregnancy Period in Patients With Inflammatory Autoimmune Diseases.
Article in ACR open rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
objectiveSystemic inflammatory conditions affect many women during their reproductive years and tumor necrosis factor inhibitors (TNFi) are one of the most common biologic classes used to help manage disease in this population. Although treatment guidelines now recommend continuing TNFi in pregnancy, studies examining recent real-world treatment trends in this population are limited. The objective of this study was to describe TNFi treatment patterns in the peripregnancy period among patients treated with TNFi before pregnancy, and to describe differences by autoimmune condition, over time.
methodsA retrospective cohort study was conducted using two US administrative health insurance claims databases: Merative MarketScan Commercial Database (CCAE) and Merative MarketScan Multi-State Medicaid Database (MDCD) between 2010 and 2022. Participants were pregnant women aged 18 to 49 years with ≥1 dispensing for TNFi in the six months before pregnancy start and a diagnosis of psoriasis (PSO), psoriatic arthritis (PsA), ulcerative colitis (UC) or Crohn's disease (CD), and/or rheumatoid arthritis (RA).
resultsThere were 6,031 pregnancies (5,025 women) in CCAE and 825 pregnancies (714 women) in MDCD included. Continuation in pregnancy was highest in UC or CD (89.3% in CCAE and 84.0% in MDCD), followed by RA (71.9% in CCAE and 71.9% in MDCD), and PSO/PsA (66.6% in CCAE and 65.7% in MDCD). Across all conditions, the proportion continuing TNFi significantly increased over time (P < 0.01).
conclusionThis study extends our understanding of peripregnancy TNFi treatment patterns in women with autoimmune diseases, illustrating an increasing trend of TNFi continuation in pregnancy across two administrative data sources in the United States.
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