Question
I read your response to the Humera/pregnancy question in March and found it informative. Thank you for posting it. At age 29, My RA and CD had rendered me mostly bed-ridden and constantly in and out of hospitals for about four years. Two years ago, Remicade “gave me my life back”. Prior to that, my husband and I had given up on the idea of ever starting a family. Today, my husband and I are excited to announce that we are pregnant! Our embryo is on its 22nd day post conception (using a healthy egg donor). Everything is going even better than expected! Delivery predicted around May 1, 2007. My last Remicade infussion was one week prior to IVF (4 vials/6 wks), and my last Methotexate injection was five months ago. I stopped my Celebrex three days prior to implantation. Surprisingly, I am doing very well, no complaints that Tylenol can’t take care of. I am hoping that I am one of the 80% of women who experience remission as a result of pregnancy. However, it would be a tremendous relief to me (prior to having to make the decision to use Remicade to finish out the pregnancy only if severe symptoms re-occur), TO BE AWARE OF ANY REPORTED SIDE-EFFECTS ON EMBRYONIC/FETAL DEVELOPMENT AND THE USE OF REMICADE (human or animal studies). My Rheumatologist reported to me that in fetal mice studies, Remicade did not pass the placental barrier. Have you heard any such results? Finally, I know you are a very busy professional; however, I personally applaud you for opening your heart to those of us who are in desperate need of specific information which we find close to impossible to locate.
Answer
There has been no studies to date that show an increase in birth defects with the TNF agents, but the studies are small. Thus we continue to stop the TNF agents during preganancy. I am not aware of the study your rheumatologist is referencing, but to my knowledge Remicade like all antibodies cross the placental barrier. Congratulations on your pregnancy!
