Ulcerative Colitis
IBD pain not well controlled during hospitalization
One-third of IBD patients do not undergo objective assessment, TDM
Keeping the ‘Enemy’ of IBD at Bay During Pregnancy and Pandemic
This month’s cover story on pregnant women with inflammatory bowel disease covered all the relevant points. The important message is that the “enemy” here is not the medication — it’s the active Crohn’s disease or active ulcerative colitis. Treating the inflammation is of paramount importance, to maximize the chance of good pregnancy outcomes. The physicians interviewed said to develop a plan where you’re continuing the biologic throughout pregnancy. Trying to develop a plan to hold the drug in the last half of pregnancy makes things more complex, so it’s easier for patients and for providers to remember to just continue the biologic throughout pregnancy. There is a safety concern that if you do hold the biologic during the last half or last third of pregnancy, that will increase the risk for postpartum flare. The last thing a new mother needs is a flare of her IBD. It’s better all-around to just continue the medication. The main exceptions to this recommendation are methotrexate, which is totally contraindicated, and then to a lesser extent tofacitinib (Xeljanz, Pfizer) just because we don’t have enough data on it.