Treatment of a pregnant Crohn’s disease patient with ustekinumab: a case report

Česká verzia

Authors: Lukešová L. ¹; Nedbalová L. ¹; Šerclová Z. ²
Authors place of work: Centrum pro biologickou léčbu nespecifických střevních zánětů, Gastroenterologie, Nemocnice Turnov, KN Liberec, a. s. ¹; Chirurgické oddělení, Nemocnice Hořovice ²
Published in the journal: Gastroent Hepatol 2019; 73(1): 43-45
Category: IBD: Case Report
doi: https://doi.org/10.14735/amgh201943

Summary

The balance between maintenance of remission and safety is important when treating idiopathic inflammatory bowel disease in pregnancy. Conception and pregnancy should be planned for the period of remission, and the therapeutic strategy leading to remission should be maintained during pregnancy and nursing. The drugs used to treat idiopathic bowel disease are relatively safe in pregnancy, except for methotrexate. A large amount of data indicate that anti-tumor necrosis factor α (TNFα) therapy in pregnancy is safe for both the mother and child. The risks of an increased infection rate, allergies, and immunodeficiencies in children of mothers who receive anti-TNFα therapy during pregnancy have not been confirmed. There is only limited experience of the use of ustekinumab in pregnancy. Although there are case reports of dermatology patients who received ustekinumab in pregnancy, the doses used in these patients are lower than those used to treat Crohn’s disease (CD). We report a CD patient who achieved clinical and laboratory remission and partial mucosal healing upon ustekinumab therapy. This effect was maintained by continuous therapy throughout pregnancy. The patient had a cesarean section at week 38 of gestation. Her daughter is healthy and continues to prosper.

Key words:

inflammatory bowel disease – anti-TNFα – infliximab – adalimumab – ustekinumab – gravidity – Crohn’s disease – biologic therapy

Submitted: 5. 2. 2019

Accepted: 10. 2. 2019

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

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