Biological therapy of ulcerative colitis during pregnancy

Česká verzia

Authors: J. Koželuhová
Authors place of work: I. interní klinika LF UK a FN Plzeň
Published in the journal: Gastroent Hepatol 2023; 77(1): 26-29
Category: IBD: kazuistika
doi: https://doi.org/10.48095/ccgh202326

Summary

The annotated case report describes the case of a patient with ulcerative colitis (UC) who was successfully treated with infliximab at the beginning of disease due to failure of conventional therapy. For a long-term remission of UC, it was decided to end biological therapy during the third trimester of pregnancy. For the relapse of UC after the delivery, the initiation of vedolizumab therapy was indicated, after which a remission of UC was achieved, and therefore VDZ maintenance treatment was continued in the following course. A new pregnancy occurred on this therapy, which developed without complications to the indicated treatment. This thesis evaluates the benefits and possible risks of biological treatment during pregnancy.

Keywords:

ulcerative colitis – pregnancy – infliximab – vedolizumab

Zdroje

1. Torres J, Chaparro M, Julsgaard M et al. European Crohn’s and colitis guidelines on sexuality, trefrility pregnancy and lactation. J Crohns Colitis. In press 2022; jjac115. doi: 10.1093/ecco-jcc/jjac115.

2. Rutgeerts P, Sandborn WJ, Feagan BG et al. Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med 2005; 353 (23): 2462–2476. doi: 10.1056/NEJMoa050516.

3. Bortlík M, Ďuricová D, Douda T et al. Doporučení pro podávání biologické léčby pacientům s idiopatickými střevními záněty: čtvrté, aktualizované vydání. Gastroent Hepatol 2019; 73 (1): 11–24. doi: 10.14735/amgh201911.

4. Bortlík M, Ďuricová D, Novotný A et al. Doporučení Pracovní skupiny pro idiopatické střevní záněty pro diagnostiku a medikamentózní léčbu ulcerózní kolitidy: Gastroent Hepatol 2022; 76 (1): 13–28. doi: 10.48095/ccgh202213.

5. Mitrova K, Pipek B, Bortlík M et al. Differences in the placental pharmacokinetics of vedolizumab and ustekinumab during pregnancy in women with inflammatory bowel disease: a prospective multicentre study. Therap Adv Gastroenterol 2021; 14: 17562848211032790. doi: 0.1177/17562848211032790.

6. Wils P, Seksik P, Stefanescu C et al. Safety of ustekinumab or vedolizumab in pregnant inflam- matory bowel disease patients: a multicentre cohort study. Aliment Pharmacol Ther 2021; 53 (4): 460–470. doi: 10.1111/apt.16192.

7. Julsgaard M, Baumgart DC, Baunwall SM et al. Vedolizumab clearance in neonates, susceptibility to infections and developmental milestones: a prospective multicentre population-based cohort study. Aliment Pharmacol Ther 2021; 54 (10): 1320–1329. doi: 10.1111/apt.16 593.

8. Moens A, van der Woude CJ, Julsgaard M et al. Pregnancy outcomes in inflammatory bowel disease patients treated with vedolizumab, anti-TNC or conventional therapy: results of the European CONCEIVE study. Aliment Pharmacol Ther 2020; 51 (1): 129–138. doi: 10.1111/apt.15539.

9. Mitrova K, Pipek B, Bortlik M et al. Safety of ustekinumab and vedolizumab during pregnancy – pregnancy, neonatal, and infant outcome: a prospective multicentre study. J Crohns Colitis 2022; 16 (12): 1808–1815. doi: 10.1093/ecco-jcc/jjac086.

10. Pipek B, Ďuricová D, Bortlík M et al. Bezpečnost biologické léčby vedolizumabem a ustekinumabem podávané v průběhu gravidity pro idiopatický střevní zánět matek – multicentrická retrospektivně-prospektivní observační studie. Gastroent Hepatol 2022; 76 (1): 46–54. doi: 10.48095/ccgh202246.

11. Bortlík M. Vedolizumab – nová antiintegrinová protilátka s vysokou gastrointestinální selektivitou. Gastroent Hepatol 2014; 68 (6): 481–484. doi: 10.14735/amgh2014481.

12. Feagan BG, Rutgeerts P, Sands BE et al. Vedolizumab as induction and maintenance therapy for ulcerative colitis. N Engl J Med 2013; 369 (8): 699–710. doi: 10.1056/NEJMoa1215739.