Title :

Young Female with Crohn’s Disease

Category :

Crohn’s Disease, Pregnancy, Safety Profile of Biologics

Drug :

Anti-TNF agents, Azathioprine, Methotrexate, Prednisone

IBD Horizon’s ACG “The Dialogue®

  • 28 year old Female with Crohn’s enterocolitis and active symptoms
  • Wants to get pregnant soon and apprehensive of starting biologic treatment
  • Discuss safety profile of biologics and risk for placental transfer.
  • What should be your pre-pregnancy work up for this patient? Evaluate disease activity with colonoscopy and cross sectional imaging. Inactive bowel disease and mucosal remission associated with best outcomes for mother and baby.
  • What is the safety profile of non-biologics and biologics during pregnancy? FDA Pregnancy Categories: Corticosteroids class C; Azathioprine class D; Anti-TNFs class B; Methotrexate class X
  • What can you do to evaluate a flare during pregnancy? Best to evaluate during 2nd trimester. Flexible sigmoidoscopy without sedation. MRI without gadolinium.
  • Is there a preferred mode of delivery? This is shared decision made with patient, obstetrician and gastroenterologist. In general, vaginal delivery is recommended unless active perianal disease or prior surgery such as IPAA/J pouch.Consensus: Evaluate disease activity before family planning. Control disease prior to conception.

Certolizumab pegol/Cimzia does not have placental transfer and may be considered as first line biologic/anti TNF treatment. Anti-TNFs as a class is considered pregnancy category B and safe with pregnancy and compatible with breastfeeding.

Waitlist Registeration
My Registration
Welcome to the registration Module
Enter your email:
My Registration
You are already registered for this meeting
Select another meeting or Exit
Select your meeting
My Registration
Enter Invitation code for Dialogue
    or     Request
My Registration
Please fill below information to request invitation code.