在患有自身免疫性疾病的患者中,在怀孕期间使用生物制剂
Celeste L Y Ewig1, Yanning Wang1,2, Nicole E Smolinski1,2
1Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville.
JAMA network open
|May 15, 2025
概括
在患有自身免疫性疾病的孕妇中,其生物使用在怀孕期间下降,但在分娩后仅部分恢复. 根据病情,使用情况有很大差异,因此需要对生物疗法进行个性化风险益处评估.
科学领域:
- 生殖免疫学 生殖免疫学
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
背景情况:
- 生物疗法对于治疗自身免疫性疾病至关重要.
- 患有自身免疫性疾病的患者怀孕需要仔细考虑疾病活性和药物安全性.
- 了解怀孕期间的生物治疗模式对于评估母亲和胎儿的结果至关重要.
研究的目的:
- 在被诊断患有自身免疫性疾病的孕妇中描述生物药物的使用模式.
- 调查特定自身免疫性疾病与怀孕期间使用生物药物的可能性之间的关联.
主要方法:
- 一项回顾性队列研究,利用来自Merative MarketScan研究数据库 (2011-2022) 的行政索赔数据.
- 包括16-55岁的怀孕患者,患有自身免疫性疾病,在怀孕前6个月内使用生物.
- 分析了不同季度和产后的生物使用情况,并通过多变量逻辑回归比较了各种自身免疫疾病的使用情况.
主要成果:
- 在6131名孕妇中,71.6%在怀孕期间使用了生物药物.
- 生物使用在怀孕期间逐渐减少 (第一季度:68.6%;第二季度:58.8%;第三季度:48.6%),并在分娩后 (77.1%) 部分反弹.
- 与类风湿性关节炎患者相比,克罗恩病和性结肠炎患者在怀孕期间更有可能使用生物药物,而牛皮/牛皮性关节炎患者的可能性较低.
结论:
- 在患有自身免疫性疾病的孕妇中,生物使用显示出在怀孕期间下降的明显模式,产后恢复不完全.
- 在不同的自身免疫性疾病中,生物利用率存在显著差异.
- 量身定制的风险益处评估对于指导自免疫性疾病的孕妇生物治疗决策至关重要.
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