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Drug Safety
Published in: Drug Safety 5/2013

01-05-2013 | Review Article

Ciclosporin Use During Pregnancy

Authors: Karolina Paziana, Magaly Del Monaco, Elyce Cardonick, Michael Moritz, Matthew Keller, Bruce Smith, Lisa Coscia, Vincent Armenti

Published in: Drug Safety | Issue 5/2013

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Abstract

Ciclosporin (cyclosporine) is an immunosuppressive drug first approved for use in organ transplantation to prevent rejection. Ciclosporin is also known to be used for the treatment of psoriasis, rheumatoid arthritis, systemic lupus erythematosus and inflammatory bowel disease, among other indications. While it is recommended that all medications that are not absolutely necessary should be avoided during pregnancy, this may not be an option for many women whose quality of life is significantly impacted without treatment, or for those who must continue immunosuppressive therapy to avoid organ rejection. The purpose of this review is to provide a comprehensive report from the literature of ciclosporin exposure during pregnancy. PubMed, MEDLINE and the Cochrane Database of Systematic Reviews were searched for English-language articles published from 1970 to 2012 that included reports of pregnant women treated at any time during pregnancy with ciclosporin. On an initial search, it was evident that much of the available information is limited to pregnancy after transplant, which suggests that ciclosporin use during pregnancy appears to be associated with premature delivery and low birthweight infants. Comorbidities such as hypertension, pre-eclampsia and gestational diabetes mellitus are also reported at higher incidences than the general population. Medical literature concerning women with autoimmune disorders exposed to ciclosporin during pregnancy are currently limited to case reports and registry data, and, as such, it is difficult to determine if any risks associated with ciclosporin therapy during pregnancy are due to exposure to the drug alone or to pre-existing maternal comorbidities. The literature suggests that ciclosporin therapy during pregnancy should be carefully considered by the treating physician, but may be a safe alternative for patients with autoimmune disease refractory to conventional treatment. Continued monitoring of this patient population remains a key component to understanding the risk factors associated with ciclosporin exposure during pregnancy.
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Metadata
Title
Ciclosporin Use During Pregnancy
Authors
Karolina Paziana
Magaly Del Monaco
Elyce Cardonick
Michael Moritz
Matthew Keller
Bruce Smith
Lisa Coscia
Vincent Armenti
Publication date
01-05-2013
Publisher
Springer International Publishing AG
Published in
Drug Safety / Issue 5/2013
Print ISSN: 0114-5916
Electronic ISSN: 1179-1942
DOI
https://doi.org/10.1007/s40264-013-0034-x

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