在怀孕和哺乳期间使用修改生物疾病的抗风湿药物
Caroline H Siegel1, Lisa R Sammaritano
1Division of Rheumatology, Hospital for Special Surgery, and the Department of Medicine, Weill Cornell Medicine, New York, New York.
Obstetrics and gynecology
|February 19, 2026
概括
生物修饰性抗风湿药物 (bDMARDs) 越来越多地用于生育年龄妇女自身免疫性风湿性疾病. 指导方针支持在怀孕期间使用bDMARD来控制母亲的疾病,其中TNF抑制剂显示了最多的安全数据.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 产妇胎儿医学 产妇胎儿医学
背景情况:
- 自身免疫性类风湿性疾病 (ARDs) 主要影响生育年龄的女性.
- 在怀孕期间管理ARD需要平衡孕产妇疾病控制与胎儿安全.
- 生物修饰性抗风湿药物 (bDMARDs) 越来越多地与传统疗法一起使用.
研究的目的:
- 审查bDMARDs在ARDs的孕妇和哺乳期妇女的使用.
- 评估bDMARDs在怀孕期间的安全性及其对婴儿疫苗接种暴露后的影响.
- 综合当前的证据和指南建议,用于怀孕期间使用bDMARDs来管理ARD.
主要方法:
- 关于bDMARD在怀孕和哺乳期间使用的当前证据的文献综合.
- 对怀孕期间ARD治疗的专业社会指导方针的审查.
- 对bDMARDs,特别是TNF抑制剂在妊娠和产后期间的安全数据的分析.
主要成果:
- 目前的指导方针一般支持在怀孕和哺乳期间使用bDMARDs以保持孕产妇疾病控制.
- 瘤坏死因子抑制剂 (bDMARDs) 拥有最广泛的安全证据,用于怀孕和哺乳期使用.
- 虽然产性不太可能,但潜在的新生儿免疫效应和未知的子宫内暴露后果需要考虑.
结论:
- 使用bDMARDs的好处往往超过风险,特别是在不耐药的孕产妇疾病中.
- 对具有新型作用机制的新型bDMARDs的证据有限.
- 进一步的研究对于在怀孕期间在ARD管理中提供个性化咨询和共享决策至关重要.
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