TNFi Exposure In Utero Does Not Up Serious Infection Risk
TUESDAY, May 22, 2018 -- Offspring born to mothers with rheumatoid arthritis (RA) who are exposed to tumor necrosis factor α inhibitors (TNFi) in the gestational period do not have a significantly increased risk of serious infections, according to a study published online May 17 in Arthritis & Rheumatology.
Évelyne Vinet, M.D., Ph.D., from McGill University Health Center in Montreal, and colleagues used U.S. claim data from 2011 to 2015 to identify 2,989 RA offspring and a randomly selected control group of 14,596 children matched for maternal age, year of delivery, and state of residence. TNFi exposure was defined based on one or more filled prescriptions during pregnancy. Serious infections were ascertained based on one or more hospitalizations with infection as a primary diagnosis by age 12 months.
The researchers found that 12.7 percent of the RA offspring were exposed to TNFi during pregnancy. The percent of serious infections was similar in RA offspring with no TNFi exposure and non-RA offspring (2.0 versus 1.9 percent), while the percent was higher among RA offspring with TNFi exposure (3.2 percent). There was no significant increase in the risk of serious infection in RA offspring exposed to TNFi compared with non-RA offspring (odds ratio, 1.7; 95 percent confidence interval, 0.8 to 3.7) or compared with RA offspring unexposed to TNFi (odds ratio, 1.4; 95 percent confidence interval, 0.7 to 2.8), in multivariable analyses.
"We did not demonstrate a marked excess risk for serious infections in RA offspring exposed to TNFi during pregnancy versus unexposed RA offspring or general population controls," the authors write.
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Posted: May 2018
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