Is Enbrel safe during pregnancy?
August 11, 2008 10:27 AM   Subscribe

I take Enbrel for Psoriatic Arthritis and I want to get pregnant. Doctors have different responses about whether I will have to stop taking it in preparation for and during pregnancy or not. Enbrel is a category B drug. Do I have to suffer joint pain and horrible skin for 9+ months?

One doctor, a rheumatologist, scared me by saying I should quit enbrel 6 or so weeks before attempting to get pregnant. I am 35 and it could take a while. I do not want to suffer while I pressure myself to get pregnant as soon as possible.

Another doctor, an OB/GYN, saw the designation as a category B drug and said no problem, keep taking it. That seemed a bit laissez-faire, but I want that to be true.

I would ideally like to find a doctor who has followed a woman through a pregnancy on Enbrel before, preferably more than one woman.

If it was just psoriasis, I would give up the Enbrel. But my last flare was so bad I could hardly walk. I exercise a lot and the pain was unbearable. I was taking a lot of advil just to be able to walk.

If you have any ideas about Enbrel's safety during pregnancy, or how to find an OB/GYN or Rheumatologist with experience with this I would appreciate it.

There is not a lot of information about this online. Some anecdotal stories about having taken it with no problems, but not a lot.
posted by marlys27 to Health & Fitness (5 answers total) 2 users marked this as a favorite
Category B:

Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies which have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.

Most drugs are category B, as Pharma doesn't want to pay for the studies for Category A -- and most pregnant women wouldn't want to be guinea pigs, either. I believe Tylenol and Motrin are both Category B, for example.

The rheumatologist has more experience with Enbrel; the OB has more experience with pregnancy.

You might try asking your OB if he or she knows anyone who deals with patients with autoimmune diseases frequently, or see if you could talk to someone in "high-risk" OB.

All this being said, our genes and environments are all different, and it's hard to say how any one person will react to a certain drug. We can say X% of patients do well or Y% will develop nausea, but when it gets down to an individual it's hard to say.
posted by gramcracker at 10:48 AM on August 11, 2008

Whoa dude, no derma I've ever taken biologics with (three so far) would ever like EVER let me take them during pregnancy. The one I'm on right now I had to actually sign saying I was either on birth control or celibate, and I have to take pregnancy tests every month for them. These drugs are soooo new and the effects on the fetus just aren't known. As you know the effects on US aren't even really known. There's no way in h-e-double-hockey-sticks I'd take them while pregnant no matter what the OB-GYN says. The OB-Gyn clearly knows shit about these drugs.

If I were you I'd go on over to the Nat'l Psoriasis Foundation message board and do some searches. I can't speak about PA but I've heard anecdotal reports of P patients being magically clear-skinned during pregnancy, that whole glowy thing you hear about.

I totally understand your apprehension -- I "only" have psoriasis (please beware minimizing that; obviously any of us on biologics necessarily have severe forms of the disease, it's not a small thing) and went I went off Raptiva I had a hellish flare. But Enbrel is verrrrry different from Raptiva and like I said, pregnancy might help you. Good luck.
posted by loiseau at 11:40 AM on August 11, 2008

This poster went off Enbrel while pregnant and back on during breastfeeding.
posted by loiseau at 11:52 AM on August 11, 2008

Arthritis is no fun, I know. I don't have first hand experience with psoriasis, but it looks like no walk in the park either.


Nine months for you. Lifetime for the kid.

Talk to your doctors about proven alternatives.

Completely anecdotal, but I know two women with rheumatoid arthritis (different, I know) who felt much better during pregnancy.
posted by Ookseer at 11:59 AM on August 11, 2008 [1 favorite]

Try calling OTIS:Organization of Teratology Information Specialists. They have a hotline #866-626-OTIS. It looks like they're doing more studies on pregnancy and autoimmune disorders. And even if the studies on Enbrel are iffy now, you could help by joining a study so women in the future have better information.

Good luck to you. I was lucky not to be diagnosed with RA until after my 2nd child, but it was still awful to have to give up breastfeeding in order to take the meds I needed to walk without pain. I hope you can find a good balance and can have a happy, healthy pregnancy.
posted by saffry at 6:38 PM on August 11, 2008 [1 favorite]

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