Few studies evaluating the use of biological medication during pregnancy include autoinflammatory patients. Below are published studies that include autoinflammatory patients. For more studies, search Pubmed.gov.
Anakinra use during pregnancy: Report of a case with Familial Mediterranean Fever and infertility – Case report of a woman who used Kineret before and during pregnancy. The authors note risk concerns, previous studies, and concluded that, “Anakinra seems to be safe in pregnancy, but there are very few data for conclusive interpretation, particularly in the first trimester. Subfertility in women with FMF is mostly the result of disease-related factors. Appropriate treatment and prevention of attacks are the key steps for fertility.”
Successful outcome of two pregnancies in patients with adult-onset Still’s disease treated with IL-1 receptor antagonist (anakinra) – “So far, there are scant data available on the effects of anakinra in pregnancy. We report two patients with AOSD who successfully gave birth while treated with anakinra during pregnancy.”
Brief Report: Anakinra Use During Pregnancy in Patients With Cryopyrin-Associated Periodic Syndromes – “Anakinra was continued during pregnancy in women with CAPS and provided significant, persistent symptom relief while continuing to prevent the long-term sequelae of CAPS. Anakinra was well tolerated. Although a causal relationship between anakinra and renal agenesis seems unlikely, further safety data are needed.”
ANTI IL-1 therapies and pregnancy outcome – This studied followed 7 pregnant women with various autoinflammatory diseases such as CAPS, TRAPS, FMF, and Still’s disease. Four were on anakinra for either all or some of their pregnancy.
A patient’s wish: anakinra in pregnancy – This reports on a Still’s patient who used anakinra throughout pregnancy and while breastfeeding without any apparent problems.
Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk – This physician’s reference book includes a chapter on anakinra in regards to fetal risk and breastfeeding. Studies regarding anakinra and pregnancy are referenced above. The breastfeeding summary states that Il-1ra (anakinra is an Il-1ra), is naturally secreted into breastmilk in healthy individuals who are not on anakinra. It states, “Because of the presence of native Il-1ra in milk, there appears to be no risk to a nursing infant from maternal administration of anakinra.”