The Successful Use of Adalimumab to Treat Active Crohn's Disease of an Ileoanal Pouch During Pregnancy

Excerpt

The use of immunosuppressive medications during pregnancy in patients with Crohn's disease is controversial. However, most clinicians would agree that both the unborn baby and the mother will do better if the mother's inflammatory bowel disease (IBD) can be controlled. Studies have shown that patients with active Crohn's disease are more likely to experience preterm labor and have babies that are small for gestational age [1]. Currently, the most potent agent approved for Crohn's disease is infliximab. This is a chimeric anti–tumor necrosis factor-alpha (TNF-α) antibody. Recently, adalimumab (Humira), a fully humanized anti–TNF-α antibody, was approved for the treatment of rheumatoid arthritis (RA) [2‐5]. Preliminary studies have demonstrated efficacy in patients with Crohn's disease, including those who have had a reaction to or lost their response to infliximab because of the development of antibodies to the murine component of this agent [6, 7]. The safety of adalimumab in pregnancy is unknown. There has only been 1 previous report of the use of adalimumab during pregnancy [8]. Herein, we report the first use of adalimumab during pregnancy to treat severe Crohn's disease of the ileoanal pouch. …