Active inflammatory bowel disease during conception and pregnancy has been associated with adverse materno-fetal outcomes. Patients are often unduly concerned about the adverse effects of biologic medications on the growing fetus, however, continuing therapy is advised, with potential risks of therapy outweighed by the risks of active maternal disease. A number of physiological changes associated with pregnancy can alter the absorption, distribution and elimination of these therapies, which may impact on their safety and efficacy. We review the current evidence regarding the effects of pregnancy on the pharmacokinetics of biologic therapies, as well as drug concentration measurements during pregnancy and at time of delivery. A greater understanding of the impact of pregnancy on the pharmacokinetics of biologic therapies and the emerging utilisation of drug concentration monitoring during pregnancy may lead to improved materno-fetal outcomes in patients with inflammatory bowel disease. (C) 2020 Elsevier Ltd. All rights reserved.
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Univ New South Wales, St George & Sutherland Clin Sch, Sydney, NSW, AustraliaUniv New South Wales, St George & Sutherland Clin Sch, Sydney, NSW, Australia
Cao, Rena H.
Grimm, Michael C.
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Univ New South Wales, St George & Sutherland Clin Sch, Sydney, NSW, AustraliaUniv New South Wales, St George & Sutherland Clin Sch, Sydney, NSW, Australia
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Univ Calif San Francisco, Div Gastroenterol, 1701 Divisadero St,120, San Francisco, CA 94115 USAUniv Calif San Francisco, Div Gastroenterol, 1701 Divisadero St,120, San Francisco, CA 94115 USA
McConnell, Ryan A.
Mahadevan, Uma
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UCSF Ctr Colitis & Crohns Dis, Div Gastroenterol, 1701 Divisadero St,120, San Francisco, CA 94115 USAUniv Calif San Francisco, Div Gastroenterol, 1701 Divisadero St,120, San Francisco, CA 94115 USA
机构:
Karolinska Inst, Ctr Pharmacoepidemiol, Dept Med Solna, Stockholm, Sweden
Danderyd Hosp, Dept Internal Med, Stockholm, SwedenKarolinska Inst, Ctr Pharmacoepidemiol, Dept Med Solna, Stockholm, Sweden
Broms, Gabriella
Friedman, Sonia
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Brigham & Womens Hosp, Div Gastroenterol Hepatol & Endoscopy, Boston, MA 02120 USAKarolinska Inst, Ctr Pharmacoepidemiol, Dept Med Solna, Stockholm, Sweden
Friedman, Sonia
Kim, Seoyoung C.
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Brigham & Womens Hosp, Dept Med, Div Pharmacoepidemiol & Pharmacoecon, 1620 Tremt St,Suite 4016, Boston, MA 02120 USAKarolinska Inst, Ctr Pharmacoepidemiol, Dept Med Solna, Stockholm, Sweden
Kim, Seoyoung C.
Wood, Mollie E.
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Harvard TH Chan Sch Publ Hlth, Boston, MA USAKarolinska Inst, Ctr Pharmacoepidemiol, Dept Med Solna, Stockholm, Sweden
Wood, Mollie E.
Hernandez-Diaz, Sonia
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Harvard TH Chan Sch Publ Hlth, Boston, MA USAKarolinska Inst, Ctr Pharmacoepidemiol, Dept Med Solna, Stockholm, Sweden
Hernandez-Diaz, Sonia
Brill, Gregory
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Brigham & Womens Hosp, Dept Med, Div Pharmacoepidemiol & Pharmacoecon, 1620 Tremt St,Suite 4016, Boston, MA 02120 USAKarolinska Inst, Ctr Pharmacoepidemiol, Dept Med Solna, Stockholm, Sweden
Brill, Gregory
Bateman, Brian T.
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Brigham & Womens Hosp, Dept Med, Div Pharmacoepidemiol & Pharmacoecon, 1620 Tremt St,Suite 4016, Boston, MA 02120 USA
Brigham & Womens Hosp, Dept Anesthesiol Perioperat & Pain Med, Boston, MA 02120 USA
Harvard Med Sch, Boston, MA 02115 USAKarolinska Inst, Ctr Pharmacoepidemiol, Dept Med Solna, Stockholm, Sweden
Bateman, Brian T.
Huybrechts, Krista F.
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Brigham & Womens Hosp, Dept Med, Div Pharmacoepidemiol & Pharmacoecon, 1620 Tremt St,Suite 4016, Boston, MA 02120 USAKarolinska Inst, Ctr Pharmacoepidemiol, Dept Med Solna, Stockholm, Sweden
Huybrechts, Krista F.
Desai, Rishi J.
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Brigham & Womens Hosp, Dept Med, Div Pharmacoepidemiol & Pharmacoecon, 1620 Tremt St,Suite 4016, Boston, MA 02120 USAKarolinska Inst, Ctr Pharmacoepidemiol, Dept Med Solna, Stockholm, Sweden