SNFGE SNFGE
 
Thématique :
- MICI
Originalité :
Très original
Solidité :
Très solide
Doit faire évoluer notre pratique :
Immédiatement
 
 
Nom du veilleur :
Professeur Vered ABITBOL-SELINGER
Coup de coeur :
 
 
The American Journal of Gastroenterology
  2018/03  
 
  2018 Mar;113(3):396-403.  
  doi: 10.1038/ajg.2017.501  
 
  Long-Term Safety of In Utero Exposure to Anti-TNFα Drugs for the Treatment of Inflammatory Bowel Disease: Results from the Multicenter European TEDDY Study  
 
  Chaparro M, Verreth A, Lobaton T, Gravito-Soares E, Julsgaard M, Savarino E, Magro F, Avni Biron I, Lopez-Serrano P, Casanova MJ, Gompertz M, Vitor S, Arroyo M, Pugliese D, Zabana Y, Vicente R, Aguas M, Bar-Gil Shitrit A, Gutierrez A, Doherty GA, Fernandez-Salazar L, Martínez Cadilla J, Huguet JM, O'Toole A, Stasi E, Manceñido Marcos N, Villoria A, Karmiris K, Rahier JF, Rodriguez C, Diz-Lois Palomares M, Fiorino G, Benitez JM, Principi M, Naftali T, Taxonera C, Mantzaris G, Sebkova L, Iade B, Lissner D, Ferrer Bradley I, Lopez-San Roman A, Marin-Jimenez I, Merino O, Sierra M, Van Domselaar M, Caprioli F, Guerra I, Peixe P, Piqueras M, Rodriguez-Lago I, Ber Y, van Hoeve K, Torres P, Gravito-Soares M, Rudbeck-Resdal D, Bartolo O, Peixoto A, Martin G, Armuzzi A, Garre A, Donday MG, Martín de Carpi FJ, Gisbert JP  
  https://www.ncbi.nlm.nih.gov/pubmed/29460920  
 
 

Abstract

OBJECTIVES:

The long-term safety of exposure to anti-tumor necrosis factor (anti-TNFα) drugs during pregnancy has received little attention. We aimed to compare the relative risk of severe infections in children of mothers with inflammatory bowel disease (IBD) who were exposed to anti-TNFα drugs in utero with that of children who were not exposed to the drugs.

METHODS:

Retrospective multicenter cohort study. Exposed cohort: children from mothers with IBD receiving anti-TNFα medication (with or without thiopurines) at any time during pregnancy or during the 3 months before conception. Non-exposed cohort: children from mothers with IBD not treated with anti-TNFα agents or thiopurines at any time during pregnancy or the 3 months before conception. The cumulative incidence of severe infections after birth was estimated using Kaplan-Meier curves, which were compared using the log-rank test. Cox-regression analysis was performed to identify potential predictive factors for severe infections in the offspring.

RESULTS:

The study population comprised 841 children, of whom 388 (46%) had been exposed to anti-TNFα agents. Median follow-up after delivery was 47 months in the exposed group and 68 months in the non-exposed group. Both univariate and multivariate analysis showed the incidence rate of severe infections to be similar in non-exposed and exposed children (1.6% vs. 2.8% per person-year, hazard ratio 1.2 (95% confidence interval 0.8-1.8)). In the multivariate analysis, preterm delivery was the only variable associated with a higher risk of severe infection (2.5% (1.5-4.3)).

CONCLUSIONS:

In utero exposure to anti-TNFα drugs does not seem to be associated with increased short-term or long-term risk of severe infections in children.

 

 
Question posée
 
L’exposition in utero des anti-TNF expose-t-elle à un risque infectieux chez l’enfant ?
 
Question posée
 
Non, ni à court terme, ni à long terme.
 
Commentaires

Etude rétrospective multicentrique européenne ayant évalué 841 enfants nés de mère ayant une MICI dont 388 exposés in utero aux anti-TNF.

 
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