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  • Open Access

How safe it is to treat pregnant FMF patients with Anakinra?

  • 1,
  • 1 and
  • 1
Pediatric Rheumatology201513 (Suppl 1) :P124

https://doi.org/10.1186/1546-0096-13-S1-P124

  • Published:

Keywords

  • Adverse Event
  • Platelet Count
  • Thrombocytopenia
  • Colchicine
  • Amyloidosis

Background

It has been reported that anakinra, an anti-IL-1R antagonist, may be a safe alternative during pregnancy in patients with various autoinflammatory syndromes (1,2).

Objectives

To assess the safety and efficacy of anakinra in pregnant FMF patients.

Methods

Five FMF patients, treated with anakinra during pregnancy were monitored for side effects, fetal and maternal outcomes.

Results

We present five FMF cases treated with Anakinra during pregnancy due to severe protracted febrile myalgia in 3, thrombocytopenia in 1 and amyloidosis in 1. One of these cases is among the 5 patients that have been previously reported (1). Throughout pregnancy no anakinra-related adverse event was observed in any of the patients. During the postpartum period one patient had an incision-site infection and the baby of the patient with thrombocytopenia also developed low platelet count which resolved with IVIG therapy. Otherwise all patients delivered normal babies. One of the patients is still pregnant and expecting twins. All of the patients, except one with colchicine intolerance continued with daily prophylactic colchicine treatment. Anakinra was terminated shortly after birth with success in all. Pregnancy-related features are listed in Table 1.
Table 1

pregnancy-related features

Case

Maternal Age

Anakinra Relation to pregnancy

USGs

Weeks at delivery or currrent gestational age

Gender of the baby/fetus

Mode of the delivery

1stminute APGAR

Follow-up duration after birth (months)

Complications after birth

1

33

started at 21st GW and used continiously until birth

normal

Birth at 36th GW

boy

C/S

8

32

No

2

28

started at 12th GW and used until birth

normal

Birth at 40th GW

girl

vaginal

10

20

No

3

31

started at 12th GW and used until birth

normal

Birth at 38th GW

boy

C/S

6

2

Methicillin-Sensitive Staphylococcus Aureus incision-site infection (treated with Tygecycline) in mother

4

24

started at 15th GW and used until birth

normal

Birth at 38th GW

boy

Vaginal

8

2

Low thrombocyte count in the baby at birth (23,000/mm3); resolved after 3 infusions of IVIG (269,000/mm3)

5

33

started at 16th GW, still using

normal

At 20th GW

Expecting 2 girls

    

Conclusions

Anakinra promises to be a safe alternative in pregnant FMF patients who are unresponsive or intolerant to colchicine. It can be administered transiently only during pregnancy and stopped after delivery.

Authors’ Affiliations

(1)
Cerrahpasa Medical Faculty, Division of Rheumatology, Department of Internal Medicine, University of Istanbul, Istanbul, Turkey

References

  1. Lachman HJ, et al: Pediatric Rheumatology. 2013, 11 (Suppl1): A269-Google Scholar
  2. Chang Z, et al: Arthritis Rheumatol. 2014Google Scholar

Copyright

© Ozdogan et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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