Psoriasis and pregnancy in the era of biologics. Case report of ustekinumab treatment during pregnancy

H. Fierens, M. Baeck Published in the journal : April 2016 Category : Dermatology

Summary :

We report the case of a successful delivery following exposure to ustekinumab during pregnancy. Though psoriasis is not uncommon in pregnant women, its treatment may prove challenging during pregnancy, especially in severe psoriasis cases. While the disease usually improves during pregnancy, its treatment must often be continued. Besides local treatment, UVB phototherapy remains the treatment of choice in moderate-to-severe psoriasis. In patients requiring a systemic treatment, biologics can be considered. Whereas limited safety results are available from studies, various follow-up registers provide reassuring data. Unexpected exposure to biologics during the first trimester of pregnancy proves unproblematic.

What is already known about the topic?

Psoriasis usually improves during pregnancy. UVB phototherapy is the treatment of choice for severe psoriasis during pregnancy. Biologics are classified as FDA pregnancy category B agents regarding their teratogenic risk.

What does this article bring up for us?

Unexpected exposure to biologics during the first pregnancy trimester seems to be safe. Biologics taken for severe and uncontrolled psoriasis before pregnancy can be continued during pregnancy. The treatment must be stopped before gestational week 30 in order to avoid immunosuppression of the newborn.

Key words

Pregnancy, psoriasis, ustekinumab