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Minimal neonatal transfer of certolizumab pegol in a Japanese patient with rheumatoid arthritis
  1. Takayoshi Morita1,
  2. Kosuke Fujimoto1,2,3,
  3. Yoshihito Shima1,
  4. Atsushi Ogata1,4,
  5. Atsushi Kumanogoh1
  1. 1Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
  2. 2Department of Mucosal Immunology, School of Medicine, Chiba University, Japan
  3. 3Division of Innate Immune Regulation, Institute of Medical Science, International Research and Development Center for Mucosal Vaccines, The University of Tokyo, Japan
  4. 4Division of Allergy, Rheumatology and Connective Tissue Disease, NTT West Osaka Hospital, Osaka, Japan
  1. Correspondence to Dr Atsushi Ogata, Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan; atsushi.ogata.mc{at}west.ntt.co.jp

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Clowse et al1 have reported minimal to no transfer of certolizumab pegol (CZP) into breast milk, and their findings have supported the continuation of CZP treatment during breast milk feeding. Rheumatoid arthritis (RA) often develops in women of childbearing age. It is generally difficult to treat these patients with methotrexate, which is the anchor drug for RA. Therefore, biologics, such as tumour necrosis factor (TNF) inhibitors, are often considered for active RA during pregnancy. However, the biologics cross the placenta from mother to fetus and transfer into breast milk during lactation. Although a meta-analysis report indicated that anti-TNF-α therapy did not increase the risks, such as congenital malformation or abortion during pregnancy, in patients with inflammatory …

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