Ustekinumab
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Ustekinumab can be used in pregnancy if advised by a specialist. Babies exposed in the womb after the first trimester might be offered some of their vaccinations later than usual.
What is it?
Ustekinumab (Pyzchiva®, Stelara®, Steqeyma®, Uzpruvo®, Wezenla®) is an antibody therapy used to treat inflammatory illnesses, including psoriasis, psoriatic arthritis, and inflammatory bowel disease.
Benefits
What are the benefits of using ustekinumab in pregnancy?
Ustekinumab reduces inflammation by stopping your immune system from attacking your 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 inflammatory bowel disease, including miscarriage and lower infant birth weight.
Risks
What are the risks of using ustekinumab in pregnancy?
Ustekinumab does not cross the placenta in the first trimester so will not directly affect your baby’s development. Only around 200 women using ustekinumab in later pregnancy have been studied. No problems were identified but further research is ideally required.
Antibody treatments given in the second and third trimesters can affect your baby’s immune system after birth. Babies exposed to ustekinumab in later pregnancy are not usually given live vaccines (such as the BCG vaccine against tuberculosis [TB]) until they are around one year old, to reduce the risk of vaccine complications.
Alternatives
Are there any alternatives to using ustekinumab in pregnancy?
Possibly. Other medicines can be used to treat inflammatory conditions during pregnancy, although these may not work as well as ustekinumab. If ustekinumab is working well to control your illness, staying on it during pregnancy may be the best option.
If you are planning a pregnancy, speak to your specialist to determine which medicine is best. This can be arranged through your GP or specialist clinic.
If you become pregnant while taking ustekinumab, you should be reviewed by your doctor as soon as possible.
No treatment
What if I prefer not to take ustekinumab during pregnancy?
It is important that inflammatory conditions are well-treated during pregnancy to avoid a flare-up of symptoms and 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 ustekinumab?
There is currently no evidence that ustekinumab 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.