VIDEO: IBD anti-TNF use in early pregnancy linked to preeclampsia risk
SAN ANTONIO — In this exclusive video from the American College of Gastroenterology Annual Meeting, Sunanda V. Kane, MD, a gastroenterologist and professor of medicine at Mayo Clinic in Rochester, Minnesota, discusses the results of a study that demonstrated that pregnant women with inflammatory bowel disease receiving anti-TNF therapy are at an increased risk for preeclampsia.
“We know that women with inflammatory bowel disease when they are pregnant are at increased risk for adverse pregnancy outcomes,” Kane told Healio Gastroenterology and Liver Disease. “Preeclampsia is one of those conditions that we believe is more prevalent in the IBD population because of the chronic inflammatory state and it’s interesting that we know that in preeclampsia that there are elevated levels of TNF-alpha.”
Kane said that the research team hypothesized that women who were receiving anti-TNF agents during pregnancy would have a reduced risk for preeclampsia compared with women with IBD who did not receive anti-TNFs during their pregnancy.
“Much to our surprise, we found that the women who developed preeclampsia were more likely to have been exposed to an anti-TNF and not less likely,” Kane said.
The researchers, Kane noted, then assessed what could have led to the results. As it turns out, the majority of the nine women receiving anti-TNF stopped therapy during their second trimester and were not exposed in the third trimester when preeclampsia occurs.
“These are very early findings, and we think it’s interesting and that we need to look further into this, and we anticipate trying to do a multicenter study to look at this to increase our numbers to see if this signal is real,” Kane said. “I think what’s going to be important is that we look at women who have had true anti-TNF exposure in their third trimester to look to see about this risk for preeclampsia.” – by Ryan McDonald
Kane SV, et al. P1406. Presented at: American College of Gastroenterology Annual Meeting; Oct. 25-30, 2019; San Antonio.
Disclosure: Kane reports serving as a consultant for AbbVie, Janssen and Samsung Bioepis.