Etanercept en el embarazo y lactancia

Borrego, L.

doi:10.1016/S0001-7310(10)70016-8

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Resumen

Etanercept es un fármaco biológico, inhibidor del factor de necrosis tumoral indicado para el tratamiento de la psoriasis grave o moderada resistente a otras terapias. Debido a que su empleo cada vez está más extendido, deberíamos conocer sus posibles efectos teratogénicos. Los datos aportados por la literatura y los estudios previos a la comercialización del producto son muy escasos, por lo que se hace necesario profundizar en la presencia de posibles riesgos mediante la experimentación en modelos animales y la realización de estudios prospectivos prolongados en humanos. Con los conocimientos actuales parece ser que la suspensión del tratamiento un mes antes de la concepción daría un margen de seguridad adecuado y la mayoría de las pacientes que se han quedado embarazadas y han suspendido el etanercept, en el momento de conocer su estado, no han tenido complicaciones. Sin embargo, los datos necesarios para recomendar etanercept en el control de la psoriasis de una mujer embarazada son muy escasos y controvertidos.

Dado que no se conocen los efectos de un posible paso de etanercept a la leche materna, en un sistema inmune todavía inmaduro y de acuerdo con el principio riesgo/beneficio, no se debiera recomendar el empleo de etanercept en mujeres en periodo de lactancia.

Palabras clave:

Etanercept

Embarazo

Lactancia

Abstract

Etanercept is a biological drug, inhibitor of the Tumor Necrosis Factor indicated for the treatment of severe or moderate psoriasis resistant to other therapies. Because its use is becoming increasingly extended, we should know its possible teratogenic effects. The data provided by the literature and studies prior to the marketing of the product are very limited. Thus, it is necessary to study the presence of possible risks more through experiments in animal models and to conduct prolonged prospective studies in humans. With the current knowledge, it seems that suspension of the treatment from one month prior to becoming pregnant would provide an adequate safety margin, and that most of the patients who have become pregnant and have suspended etanercept as soon as they knew they were pregnant have not had any complications. However, the data needed to recommend etanercept for the control of psoriasis of a pregnant woman are very limited and controversial.

Since the effects of a possible transfer of etanercept to maternal milk in a still-immature immune system are not known, in accordance with the risk/benefit principle, the use of etanercept should not be recommended in breast-feeding women.

Keywords:

Etanercept

Pregnancy

Breast-feeding

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