Gastroenterologie
a hepatologie

Biological therapy of ulcerative colitis during pregnancy

Jana Koželuhová ^{Orcid.org  1}

+ Affiliation
¹ I. interní klinika LF UK a FN Plzeň

Summary

The annotated case report describes the case of a patient with ulcerative colitis (UC) who was successfully treated with infliximab at the beginning of disease due to failure of conventional therapy. For a long-term remission of UC, it was decided to end bio­logical therapy during the third trimester of pregnancy. For the relapse of UC after the delivery, the initiation of vedolizumab therapy was indicated, after which a remission of UC was achieved, and therefore VDZ maintenance treatment was continued in the following course. A new pregnancy occurred on this therapy, which developed without complications to the indicated treatment. This thesis evaluates the benefits and possible risks of bio­logical treatment during pregnancy.

Keywords

ulcerative colitis, gravidity, infliximab, vedolizumab

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Literature

1. Torres J, Chaparro M, Julsgaard M et al. European Crohn’s and colitis guidelines on sexuality, trefrility pregnancy and lactation. J Crohns Colitis. In press 2022; jjac115. doi: 10.1093/ecco-jcc/jjac115.
2. Rutgeerts P, Sandborn WJ, Feagan BG et al. Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med 2005; 353(23): 2462–2476. doi: 10.1056/NEJMoa050516.
3. Bortlík M, Ďuricová D, Douda T et al. Doporučení pro podávání bio­logické léčby pacientům s idiopatickými střevními záněty: čtvrté, aktualizované vydání. Gastroent Hepatol 2019; 73(1): 11–24. doi: 10.14735/amgh201911.
4. Bortlík M, Ďuricová D, Novotný A et al. Doporučení Pracovní skupiny pro idiopatické střevní záněty pro dia­gnostiku a medikamentózní léčbu ulcerózní kolitidy: Gastroent Hepatol 2022; 76(1): 13–28. doi: 10.48095/ccgh202213.
5. Mitrova K, Pipek B, Bortlík M et al. Differences in the placental pharmacokinetics of vedolizumab and ustekinumab during pregnancy in women with inflammatory bowel disease: a prospective multicentre study. Therap Adv Gastroenterol 2021; 14: 17562848211032790. doi: 0.1177/17562848211032790.
6. Wils P, Seksik P, Stefanescu C et al. Safety of ustekinumab or vedolizumab in pregnant inflam­- matory bowel disease patients: a multicentre cohort study. Aliment Pharmacol Ther 2021; 53(4): 460–470. doi: 10.1111/apt.16192.
7. Julsgaard M, Baumgart DC, Baunwall SM et al. Vedolizumab clearance in neonates, susceptibility to infections and developmental mile­stones: a prospective multicentre population-based cohort study. Aliment Pharmacol Ther 2021; 54(10): 1320–1329. doi: 10.1111/apt.16 593.
8. Moens A, van der Woude CJ, Julsgaard M et al. Pregnancy outcomes in inflammatory bowel disease patients treated with vedolizumab, anti-TNC or conventional therapy: results of the European CONCEIVE study. Aliment Pharmacol Ther 2020; 51(1): 129–138. doi: 10.1111/apt.15539.
9. Mitrova K, Pipek B, Bortlik M et al. Safety of ustekinumab and vedolizumab during pregnancy – pregnancy, neonatal, and infant outcome: a prospective multicentre study. J Crohns Colitis 2022; 16(12): 1808–1815. doi: 10.1093/ecco-jcc/jjac086.
10. Pipek B, Ďuricová D, Bortlík M et al. Bezpečnost bio­logické léčby vedolizumabem a ustekinumabem podávané v průběhu gravidity pro idiopatický střevní zánět matek – multicentrická retrospektivně-prospektivní observační studie. Gastroent Hepatol 2022; 76(1): 46–54. doi: 10.48095/ccgh202246.
11. Bortlík M. Vedolizumab – nová antiintegrinová protilátka s vysokou gastrointestinální selektivitou. Gastroent Hepatol 2014; 68(6): 481–484. doi: 10.14735/amgh2014481.
12. Feagan BG, Rutgeerts P, Sands BE et al. Vedolizumab as induction and maintenance therapy for ulcerative colitis. N Engl J Med 2013; 369(8): 699–710. doi: 10.1056/NEJMoa1215739.