Artikel
Transplacental passage of belimumab during pregnancy and follow-up of a child exposed in utero
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Autoren
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Monika Østensen
- Sørlandets Hospital Kristiansand, Rheumatologie, Kristiansand
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Helle Bitter
- Sørlandet sykehus Kristiansand, Arendal og Flekkefjord, Rheumatology, Kristiansand
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David Warren
- Universitätsklinikum Oslo, Rikshospitalet, Medical Biochemistry, Oslo
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Nils Bolstad
- Sørlandets Hospital Kristiansand, Rheumatologie, Kristiansand
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Anne Noraas
- Spezialistenpraxis, Rheumatologie, Kristiansand
| Veröffentlicht: | 30. August 2023 |
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Gliederung
Text
Introduction: Transplacental passage of BEL has not been studied in humans. We have studied the transfer of BEL as well as B-cell levels in a mother-and-child pair exposed to BEL in pregnancy. A 29-year-old woman with SLE was treated with BEL 10 mg/kg/month in her 2nd pregnancy in addition to prednisone, azathioprine (AZA) and hydroxychloroquine (HCQ). She received the last infusion of BEL at gestational week 26. She experienced no complications during pregnancy and delivered a healthy boy at gestational week 40.
Methods: Blood samples from the mother and the child were taken at delivery and at 4 and 7 months after delivery. CD19+B-cells were measured by flow cytometry. BEL levels were determined using a drug-capture assay [1].
Results: Table 1 [Tab. 1].
Conclusion: B-cell numbers in the child were reduced at birth but were within normal reference values by 4 months post-partum when BEL was undetectable in serum. The child developed normally, had no infection during the first year of life and responded normally to vaccination at 3 and 5 months of age with a high anti-pneumococcus titer at 7 months [2].
References
- 1.
- Klaasen RA, Egeland EJ, Chan J, Midtvedt K, Svensson M, Bolstad N, Fellström B, Holdaas H, Åsberg A, Bergan S, Vethe NT, Warren DJ. A Fully Automated Method for the Determination of Serum Belatacept and Its Application in a Pharmacokinetic Investigation in Renal Transplant Recipients. Ther Drug Monit. 2019 Feb;41(1):11-8. DOI: 10.1097/FTD.0000000000000580
- 2.
- Bitter H, Bendvold AN, Østensen ME. Lymphocyte changes and vaccination response in a child exposed to belimumab during pregnancy. Ann Rheum Dis. 2018 Nov;77(11):1692-3. DOI: 10.1136/annrheumdis-2018-213004
