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María Chaparro Servicio de Aparato Digestivo H. U. de La Princesa

Long-term safety of in utero exposure to anti-TNF drugs for the treatment of inflammatory bowel diseases. María Chaparro Servicio de Aparato Digestivo H. U. de La Princesa. IgG transplacental transfer. Chaparro M and Gisbert JP. Current Pharmaceutical Biotechnology 2011.

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María Chaparro Servicio de Aparato Digestivo H. U. de La Princesa

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  1. Long-term safety of in utero exposure to anti-TNF drugs for the treatment of inflammatory bowel diseases María Chaparro Servicio de Aparato Digestivo H. U. de La Princesa

  2. IgGtransplacental transfer Chaparro M and Gisbert JP. Current Pharmaceutical Biotechnology 2011

  3. PIANO: a 1000 Patient Prospective Registry of Pregnancy Outcomes in Women With IBD Exposed to Immunomodulators and Biologic Therapy AIM To determine the complication rates are higher among women with IBD and children exposed to AZA, MP, or anti-TNF agents during pregnancy compared to women with IBD who do not take these medications

  4. RESULTS • Infant height, weight and developmental milestones, adjusted for disease activity, were similar among infants in all groups at 4, 9 and 12 months of age • Significant increase in infant infections from 9 to 12 months of age in the combo therapy group relative to the unexposed group (RR =1.5)

  5. CONCLUSIONS • Anti-TNF and immunosuppressants was not associated with an increase in congenital anomalies, abnormal newborn growth and development or other complications • Increase in infections from 9 to 12 m among infants exposed to a combo during pregnancy merits further investigation • As drug should no longer be detectable in infants at 9 to 12 m, this finding may suggest dysfunctional immune development • Infants will continue to be followed until 4 years of age

  6. ?

  7. Objective To estimate the relative risk of severe infections in children from IBD mothers who have been exposed in utero to anti-TNFα drugs

  8. Secondaryobjectives • To compare the prevalence of malformations in children exposed in utero to anti- TNFα drugs with those without exposition • To evaluate the relative risk of developing neoplasia in anti-TNFα exposed children • To know the relative risk of any complication in children exposed to anti-TNF drugs

  9. Methods Exposed cohort: Children from mothers treated with anti-TNFα drugs Non-exposed cohort: Children from mothers treated neither with anti-TNFα drugs nor with thiopurines

  10. Severeinfection

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