Study Reveals How RA Drugs Affect Expectant Mothers

June 3, 2018

A Canadian study has exciting findings about offspring exposed to tumor necrosis factors.

Rheumatoid Arthritis (RA) drugs can be administered to expectant mothers without any increased health risks to unborn babies, according to a new study conducted by the Research Institute of the MUHC (RI-MUHC) in Montreal.

RA, an autoimmune disease which causes chronic inflammation of the joints and other areas of the body, affects nearly 1% of the world’s adult population and women are three times as likely to be impacted. And there is no cure.

Évelyne Vinet, MD, PhD, a scientist with the Infectious Diseases and Immunity in Global Health Program at the RI-MUHC and an assistant professor in the department of medicine and division of rheumatology at the Faculty of Medicine of McGill University, served as lead author for the study, which was published in Arthritis & Rheumatology.

“The goal of our study was to assess if offspring exposed to tumor necrosis factors (TNF) inhibitors-a drug commonly used to manage rheumatoid arthritis-have an increased risk of serious infection compared to unexposed RA offspring and children from the general population,” Vinet says.

The study involved approximately 3,000 children from mothers with RA, which Vinet shares was the largest cohort ever assembled, and a random selected group of about 15,000 children over the course of their first year of life.

Of those in the RA group, 380 children were exposed to TNFs and 3.2% presented serious infections. Those findings are just slightly higher than those with no TNFs (2%) and the control group (1.9%).

According to the study’s findings, although TNFs cross the placenta, the drug may not increase immunosuppression nor compromise a child’s ability to fight infections. Additionally, the researchers did not find any marked excess risk of serious side effects when compared to unexposed children from mothers with RA and children from the general population.

The results of the study showed that expectant mothers with RA can rest easy knowing that it has little impact on their children.

“We did not observe a marked excess risk for serious infections in RA offspring exposed to TNFi versus unexposed RA offspring and children from the general population,” Vinet says. “Knowing there is not necessarily a strong association between these RA drugs and infections in offspring will be very reassuring to expectant mothers.”

Moreover, she notes it’s important to highlight these findings so would-be mothers with the disease know they can enjoy a normal pregnancy without being burdened by any unnecessary stress.

With the results painting a strong picture, Vinet would like to see the study extended to all offspring exposed to TNFi during pregnancy, i.e., not just those born to mothers with RA, but all children born to mothers with inflammatory bowel diseases, spondyloarthropathies, psoriatic arthritis, etc.

“Until further studies are conducted to address this issue, it is important to follow current recommendations when treating women during pregnancy,” she says. “These recommendations suggest discontinuing certain TNF inhibitors before the end of pregnancy to minimize the risk of infections in offspring.”

Keith Loria is a graduate of the University of Miami, He is an award-winning journalist who has been writing for major newspapers and magazines for close to 20 years, on topics as diverse as sports, business and healthcare. You can view some of his recent writing at keithloria.contently.com.