Background During the last sixteen years, biologics have been used in our centre in an open prospective study for the treatment of refractory JIA not only in paediatric age but also in young adults.
Objectives To underline the capability to become pregnant, not negatively influenced by biologics and to describe the pregnancy outcome of our young patients who got pregnant during the biologics treatment, since this event seems to be facilitated from a low disease activity under biologics.
Methods Seventeen women affected by refractory JIA became pregnant during biologic therapy. Two males affected by JIA, both treated with Adalimumab have been achieved as indirect pregnancies. All patients had a long lasting refractory polyarticular disease not responsive to DMARDs. Patients were treated with biological agents like Etanercept (9 patients), Adalimumab (4 patients), Golimumab (3 patients), Infliximab (1 patient) and Rituximab (2 patients) as monotherapy and most of the cases after multiple switches.
Results 3 patients decided for an elective termination; 16 patients had a normal pregnancy resulted in live born infants, full term, with no structural abnormalities and still in good health. The median time of exposure to biologics was 48 months (min 10- max 72 months). No abnormalities were achieved neither in the live born infants nor in the fetuses of the pregnancies which ended with an elective termination. The paternal exposure did not influence conception and was not associated with negative outcome of pregnancy.
Conclusions The availability of therapies like antiTNFa and other biologics has raised important questions about pregnancy outcome in female and male patients affected by JIA exposed to biologics. Other data regarding limited populations affected by Crohn's disease or Rheumatoid Arthritis treated with antiTNFa have been published. It doesn't seem to be an increased risk to pregnancy loss. Even if there is no increase in miscarriage or malformation or birth defect, as reported in letterature, TNFa inhibitors are raccomended to be discontinued after pregnancy detection. In our experience no complications or unexpected side effects on the course of pregnancy were observed.
Disclosure of Interest None declared