| Theme |
Treatment for children, pregnant women and elderly patients with IBD |
| Title |
Use of IBD drugs during pregnancy and lactation |
| Author |
Eiko Saito |
Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital |
| Author |
Toshifumi Hibi |
Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital |
| [ Summary ] |
Inflammatory bowel disease (IBD) often affects women in their reproductive years. Most drugs used to treat IBD have proven to be safe during pregnancy and lactation. In contrast, current studies suggest that complications associated with IBD during pregnancy worsen perinatal outcomes. 5-ASA derivatives, corticosteroids and biologics present low risk during pregnancy and lactation. Immunomodulators (IM) are contraindicated during pregnancy in Japanese package inserts. However, recent studies have indicated that fetal exposure to IMs does not increase the risk of adverse pregnancy outcomes. Limited small studies of female patients after transplantation suggest that calcineurin inhibitors probably present a low risk during pregnancy, but results are unclear concerning lactation. Metronidazole and ciprofloxacin should be avoided in the first trimester of pregnancy, and methotrexate and thalidomide are contraindicated during both pregnancy and lactation. |