Patients with autoimmune diseases are often particularly worried when they become pregnant as it brings a lot of uncertainty to their treatment. They may ask how autoimmune disease in pregnancy differs from autoimmune disease in a normal adult? Will I need to change my drug regime? Will my I have an autoimmune flare up? However today some good news has emerged that takes uncertainty away from a pregnant woman with autoimmune disease. A cohort study presented at the American College of Rheumatology annual meeting could provide hope to woman worried about autoimmune flare-ups…
Stopping Autoimmune Flare Ups
Autoimmune diseases are a wide ranging category of disease that all have one thing in common. The bodies immune system attacks itself with “autoantibodies”. Usually antibodies fight foteign invaders like bacteria. But in these diseases those defences turn on the very thing they are trying to protect. Explaining every autoimmune disease here would be impossible, and many doctors spend their entire careers treating and studying these disease (they are called Rheumatologists) but below are a few examples of common autoimmune diseases:
- Type 1 diabetes – This is a very common disease. You might know it as the “young diabetes” aka it is often from a very young age and has no associated with obesity like type 2 diabetes
- Rheumatoid Arthritis – this is a disease that often manifests in women in their 30’s. They get achey joints and experience extreme tiredness. However the disease often gets better not worse in pregnancy
Many of these diseases need powerful drugs to stop woman getting autoimmune flare ups . One example of this is biologics, a new type of powerful treatment that directly targets the molecules causing the disease. In fact, they themselves are antibodies and work to block the immune system! Examples include:
* NOTE: the names of these drugs may seem odd, but they actually make perfect sense. mab stands for monoclonal antibody, which all of these biological agents are. When you see mab on the end of the drug name – you know its a biologic!*
Can Biologics be used in pregnancy?
As these drugs are powerful inhibitors of the immune system some doctors have worried whether giving them could cause opportunistic infections in the mothers babies. Doctors worried that if pregnant women were being immunosuppressed – would that lead to their babies being immunosuppres and getting lots of infection when they were born? Reassuringly a new study by a group of researchers at the University of California, San Diego have found that babies of mothers on these drugs did NOT have an increased risk of picking up infections after they were born compared with babies whose mothers were not on the drugs. This good news means pregnant women in need of biologics for their autoimmune disease can rest easy in knowing that their doctors can continue prescribing these drugs in order to stop their autoimmune flare ups.