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Case Report

Continuous Use of Etanercept During Pregnancy Does Not Affect TNF-Alpha Levels in Umbilical Cord Blood

ORCID Icon, &
Pages 17-19 | Published online: 31 Mar 2022
 

Abstract

TNF-alpha-targeted therapies during pregnancy is a topic of interest in rheumatology. Etanercept (ETN) is expected to have lower transplacental transfer, however, clinical evidence is lacking on the usefulness and safeness of continuing etanercept throughout pregnancy. We here described the first reported case of relapsing polychondritis where continuous use of ETN throughout pregnancy was required. The patient was a pregnant Japanese woman who presented with bilateral ear cartilage redness, swelling, saddle nose and severe subglottic oedema. Due to severe systemic and life-threatened disease, we decided to continue using ETN throughout pregnancy and resulted in successful vaginal delivery. The treatment with ETN was successful and TNF-alpha levels in umbilical cord blood were not affected. The infant did not have any signs of chondritis although levels of anti-type 2 collagen antibodies in maternal and umbilical cord blood were similar, suggesting that anti-type 2 collagen antibodies crossed the placenta. This case is an important clinical experience that strengthens the safety to continue ETN during the entire pregnancy if necessary.

Consent Statements

Patient samples were obtained after informed consent was provided by the subjects, in accordance with the Declaration of Helsinki and with approval from the ethical review board of the Graduate School of Medicine, Osaka University, Japan (no. 18370-3 and no. 11122-5). Consent of patient was obtained according to CARE guideline, using Patient Consent Form (provided by the Taylor & Francis group). Consent to publish the report is also obtained.

Disclosure

The authors have declared no conflicts of interest in this work.

Additional information

Funding

This study was funded by the Japan Society for the Promotion of Science (JSPS) KAKENHI (JP18H05282 to A.K.).