Differences in the placental pharmacokinetics of vedolizumab and ustekinumab during pregnancy in women with inflammatory bowel disease: a prospective multicentre study

被引：24

作者：

Mitrova, Katarina ^{[4
,5
,6
]}

Pipek, Barbora ^{[1
,2
,3
]}

Bortlik, Martin ^{[7
,8
,9
]}

Bouchner, Ludek ^{[10
]}

Brezina, Jan ^{[11
]}

Douda, Tomas ^{[12
,13
]}

Drasar, Tomas ^{[14
]}

Drastich, Pavel ^{[11
]}

Falt, Premysl ^{[2
,3
,12
,13
]}

Klvana, Pavel ^{[15
]}

Leksa, Vaclav ^{[16
]}

Novotny, Ales ^{[17
]}

Svoboda, Pavel ^{[18
,19
]}

Skorpik, Jan ^{[20
]}

Ulbrych, Jan ^{[21
,22
]}

Veinfurt, Marek ^{[23
]}

Zborilova, Blanka ^{[23
]}

Lukas, Milan ^{[6
]}

Duricova, Dana ^{[6
,24
]}

机构：

[1] Hosp AGEL Vitkovice, Digest Dis Ctr, Zaluzanskeho 1192-15, Ostrava Vitkovice 70030, Czech Republic

[2] Palacky Univ, Fac Med & Dent, Dept Internal Med Gastroenterol & Geriatr 2, Olomouc, Czech Republic

[3] Univ Hosp, Olomouc, Czech Republic

[4] Charles Univ Prague, Fac Med 2, Dept Paediat, Prague, Czech Republic

[5] Motol Univ Hosp, Prague, Czech Republic

[6] Charles Univ Prague, Clin & Res Ctr Inflammatory Bowel Dis, ISCARE As, Prague, Czech Republic

[7] Charles Univ Prague, Dept Gastroenterol, Hosp Ceske Budejovice, Fac Med 1,Inst Pharmacol, Prague, Czech Republic

[8] 1st Fac Med, Dept Internal Med, Prague, Czech Republic

[9] Cent Mil Hosp, Prague, Czech Republic

[10] Univ Hosp Plzen Bory, Dept Internal Med, Plzen, Czech Republic

[11] Inst Clin & Expt Med, Dept Hepatogastroenterol, Prague, Czech Republic

[12] Charles Univ Prague, Dept Gastroenterol 2, Fac Med & Dent, Prague, Czech Republic

[13] Univ Hosp Hradec Kralove, Hradec Kralove, Czech Republic

[14] Liberec Reg Hosp, IBD Ctr Turnov, Liberec, Czech Republic

[15] Hosp Frydek Mistek, Beskydy Gastroctr, Frydek, Czech Republic

[16] Pardubice Hosp, Internal Dept, Endoscopy, Pardubice, Czech Republic

[17] Charles Univ Prague, Gen Univ Hosp, Internal Clin 4, Prague, Czech Republic

[18] Univ Ostrava, Fac Med, Dept Internal Med, Ostrava, Czech Republic

[19] Univ Hosp Ostrava, Dept Internal Med, Ostrava, Czech Republic

[20] Hosp Jihlava, Dept Gastroenterol, Jihlava, Czech Republic

[21] St Annes Univ Hosp Brno, Dept Internal Med 2, Brno, Czech Republic

[22] SurGal Clin, Brno, Czech Republic

[23] Hosp Karlovy Vary, Dept Gastroenterol, Karlovy Vary, Karlovarsky, Czech Republic

[24] Charles Univ Prague, Fac Med 1, Inst Pharmacol, Prague, Czech Republic

来源：

THERAPEUTIC ADVANCES IN GASTROENTEROLOGY | 2021年 / 14卷

关键词：

pregnancy; ustekinumab; vedolizumab; CROHNS-DISEASE; PSORIASIS; MOTHERS;

D O I：

10.1177/17562848211032790

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: Vedolizumab demonstrated different placental pharmacokinetics than other immunoglobulin G1 antibodies, leading to lower drug levels in cord blood in contrast to maternal blood at the time of delivery. The placental transfer of ustekinumab seems to have a pattern similar to anti-tumour necrosis factor agents. Current evidence on the placental pharmacokinetics of vedolizumab and ustekinumab is limited. We aimed to assess the placental transfer of ustekinumab and vedolizumab in pregnant patients with inflammatory bowel disease. Methods: Consecutive women from a prospective observational study who were exposed to ustekinumab or vedolizumab within 2 months prior to conception or during pregnancy were included. Ustekinumab and vedolizumab levels were measured in maternal and cord blood at the time of delivery. Results: Drug levels were available in 31 infant-mother pairs (15 exposed to ustekinumab and 16 to vedolizumab). The median maternal and newborn ustekinumab levels were 5.3 mg/l and 10.3 mg/l, respectively (the median infant-to-maternal ratio was 1.7), while the median maternal and cord vedolizumab levels were 7.3 mg/l and 4.5 mg/l (the median infant-to-maternal ratio was 0.66). The ustekinumab levels in cord blood positively correlated with the maternal levels at delivery (rho = 0.751, p = 0.001). However, no correlation with the timing of the last drug administration was found. In contrast, the vedolizumab levels in cord blood demonstrated significant positive correlation with the maternal levels (rho = 0.831, p < 0.001) along with the gestational week of the last infusion (rho = 0.736, p = 0.001). Conclusion: Vedolizumab demonstrated different placental pharmacokinetics, leading to lower drug levels in cord blood compared to maternal blood at delivery; in contrast, the placental transfer of ustekinumab seems to have a pattern similar to anti-tumour necrosis factor (TNF) agents.

引用

页数：9

共 19 条

[1]

[Anonymous], 2019, GASTROENTEROLOGY, DOI DOI 10.1053/j.gastro.2018.12.022

[2] Pregnancy and newborn outcome of mothers with inflammatory bowel diseases exposed to anti-TNF-α therapy during pregnancy: three-center study [J].