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No increased infection risk after in utero anti-TNF alpha exposure
Anti-tumor necrosis factor alpha exposure in utero did not appear to have a long-term impact on a child’s development, including their immune system and psychomotor development, according to research published in Inflammatory Bowel Diseases.
Dana Duricova, MD, PhD, of the IBD Clinical and Research Center at ISCARE IVF in the Czech Republic, and colleagues wrote that drug levels in children born to mothers with IBD and treated with anti-TNF alpha often persist up to 12 months after birth.
“There is already solid evidence of a favorable safety profile of anti-TNF alpha preparations on pregnancy and short-term newborn outcome,” they wrote. “However, data on the impact of prenatal anti-TNF-alpha exposure on long-term development of exposed children, mainly on their immune system, are still sparse, and there is a need for further evidence.”
Researchers sought to determine the long-term safety of in utero anti-TNF alpha exposure by following a group of children born to mothers with IBD between 2007 and 2016 (n = 72; mean age, 35 months). They compared data from the group on perinatal period, psychomotor development, vaccination, infections, antibodies and allergies with a control group of children born to mothers without IBD (n = 69; mean age, 50 months).
Duricova and colleagues found no significant difference in infectious complications within the first year of life between anti-TNF exposed and non-exposed children (23.9% vs. 17.4%) or during the entire follow-up period. Concomitant immunosuppressant therapy and anti-TNF levels in cord blood were also not associated with an increased infection rate during the first year of life.
Children from both groups had similar growth and psychomotor development, and researchers did not find a significant link between anti-TNF exposure and risk for developing an allergy.
Duricova and colleagues wrote that future studies are needed to assess the long-term impact of prenatal anti-TNF exposure, especially research on new biologic preparations with different mechanism of action.
“The biggest concern regarding anti-TNF alpha exposure in utero is about its influence on the developing immune system of exposed children,” they wrote. “In our study, we did not find any significant difference in the proportion of children experiencing infectious complications requiring antibiotics and/or hospitalization comparing the exposed group and the control group, either within the first year of life or during the whole follow-up period.” – by Alex Young
Disclosures: Duricova reports financial ties to AbbVie, Takeda and Janssen. Please see the full study for all other authors’ relevant financial disclosures.