LETTER

Etanercept during pregnancy and lactation in a patient with rheumatoid arthritis: drug levels in maternal serum, cord blood, breast milk and the infant’s serum

A Murashima^1,2, N Watanabe^1,2, N Ozawa¹, H Saito¹, K Yamaguchi^1,2

¹ Department of Perinatology, National Center for Child Health and Development, Tokyo, Japan
² Japan Drug Information Institute in Pregnancy, Tokyo, Japan

Correspondence to:
^{Correspondence to} Dr A Murashima, Division of Maternal Medicine, Department of Perinatology, National Center for Child Health and Development, Okura 2-10-1, Setagaya-ku, Tokyo 157-8535, Japan; murasima-a@ncchd.go.jp

Accepted 5 February 2009

The first 150 words of the full text of this article appear below.

Women with rheumatoid arthritis (RA) appear to be at a high risk of preterm delivery, preeclampsia and low birth weight infants.¹ Reduction of inflammatory activity is of particular importance in those desirous of having children.^{2 3} The use of disease-modifying antirheumatic drugs, including biological preparations, has been shown to be essential for suppression of the activity of RA. Tumour necrosis factor inhibitors have been introduced for the treatment of RA, with the expectation of obtaining immediate and certain effect. Although no teratogenicity of these drugs has been recognised in animal experiments,^{4 5} the safety of their use in pregnancy has not yet been adequately established. In this report, we discuss the clinical usefulness of etanercept with reference to the drug concentration in maternal and neonatal blood and breast milk.

A 40-year-old active RA patient (51.5 kg body weight; 153 cm height; body mass index 22), with a past history of two miscarriages . . . [Full text of this article]

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