Adalimumab
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Adalimumab can be used in pregnancy to treat inflammatory illnesses. Babies who were exposed in later pregnancy might be offered some of their vaccinations at a later time than usual.
What is it?
Adalimumab (Humira) is an antibody therapy used to treat inflammatory illnesses, including psoriasis, Crohn’s disease, ulcerative colitis, and certain types of arthritis.
Benefits
What are the benefits of using adalimumab in pregnancy?
Adalimumab reduces inflammation by stopping the immune system from attacking the body’s tissues. This is important to reduce unpleasant symptoms and prevent long-term damage. It may also lower the chance of some pregnancy problems linked to uncontrolled inflammation, including miscarriage and lower infant birth weight.
Risks
What are the risks of using adalimumab in pregnancy?
Use of adalimumab in pregnancy has been studied in around 1,500 women. There is no suggestion that adalimumab affects the baby’s development, but ongoing data collection is ideally required to confirm this.
Adalimumab used in later pregnancy can potentially affect the baby’s immune system for several months after birth. Live vaccines should be avoided during this time. This means that the baby cannot be vaccinated against rotavirus (as this needs to be completed by four months) and is unlikely to be offered the BCG vaccine (if required) until they are at least six months old. A doctor will be able to advise about the best time for the baby to be given any live vaccinations.
Alternatives
Are there any alternatives to using adalimumab in pregnancy?
Yes. Other medicines can often be used to treat inflammatory conditions during pregnancy, although for some women these may not work as well as adalimumab.
Some women may find that their symptoms improve during pregnancy; if so, their specialist may advise that their medicine(s) can be altered or stopped. However, women should not change or stop their medication without speaking to their doctor.
Women who are planning a pregnancy should speak to their specialist to determine which medicine is best. This can be arranged through the GP or specialist clinic.
If a woman becomes pregnant while taking adalimumab she should be reviewed by her doctor as soon as possible.
No treatment
What if I prefer not to take adalimumab during pregnancy?
It is important that inflammatory conditions are well-treated during pregnancy in order to avoid a flare-up of symptoms and to reduce the chance of certain pregnancy complications. A doctor will be happy to discuss any concerns.
Will I or my baby need extra monitoring?
As part of routine antenatal care in the UK, women are invited for a very detailed scan at around 20 weeks of pregnancy to check the baby’s development. No further scans to check for birth defects will be required, although extra growth scans may be offered.
Are there any risks to my baby if the father has used adalimumab?
There is currently no evidence that adalimumab used by the father can harm the baby through effects on the sperm.
Who can I talk to if I have questions?
If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.