In their study, Gaby Eliesen and colleagues combined clinical observations with preclinical studies. In clinical work, the placental drug disposition was studied in women with autoimmune diseases who were treated with TNF inhibitors throughout pregnancy. In the preclinical studies, fetal and maternal circulations of term human, TNF-inhibitor-naïve, placentas were re-established immediately after birth. In a controlled laboratory setting, it was then studied how the placenta handled the drugs in the initial six hours after first exposure ex vivo.
A main finding of the study was that infliximab concentrations in placenta tissue reached markedly higher levels than etanercept. This was observed both in the clinical cases as well as in the ex vivo perfused placentas. The authors indicate that the difference in placental tissue exposure may be of clinical relevance and warrants further investigation. More specifically, future studies should look into the occurrence of placental TNF inhibition and possible consequences thereof.
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RIMLSRIHSHealth EvidenceObstetrics and Gynaecology Pharmacology and Toxicology ResearchDonders Institute
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