ANN RHEUM DIS:培化舍珠单抗在孕期无胎盘转移

2017-10-15 xiangting MedSci原创

CZP从母亲到婴儿的胎盘转移不存在或极少量,这表明在妊娠晚期不存在宫内胎儿暴露。

患慢性炎症性疾病的女性在怀孕期间需要有效和安全的治疗手段。这项研究评估了培化舍珠单抗(CZP)从孕妇到婴儿的胎盘转移。CZP是一种无Fc抗肿瘤坏死因子药物。

CRIB是一项药物动力学(PK)研究,孕周≥30周的女性因局部获批适应症接受CZP治疗(最后一次给药到分娩间隔时间≤35天)。在分娩时从母亲,脐带和婴儿收集血液样本,并在分娩后第4和8周再次收集婴儿血液样本。用高灵敏度和CZP特异性电化学发光免疫测定(定量下限为0.032μg/mL)CZP的血浆浓度。

共16名女性进入并完成了研究。分娩时产妇CZP血浆水平在预期的治疗范围内(中位数[范围] 24.4 [5.0-49.4]μg/mL)。在16个婴儿中,2个被排除:其中1个由于缺少出生时的数据,1个由于不合理的PK数据。其余14个婴儿中,13个出生时无可量化的CZP水平(<0.032μg/mL),1例CZP水平很低(0.042μg/ mL)(婴儿/母亲血浆比为0.0009)。没有婴儿在第4周和第8周有可量化的CZP水平。在16个脐带样本中,1个由于缺少数据被排除在外; 3/15有可量化的CZP水平(最大值0.048μg/mL)。

CZP从母亲到婴儿的胎盘转移不存在或极少量,这表明在妊娠晚期不存在宫内胎儿暴露。这些结果支持在必要时,怀孕期间可以继续CZP治疗。

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ANN RHEUM DIS:培化舍珠单抗几乎不会转移到母乳中!

当可量化时,CZP浓度为<3×LLOQ(用治疗剂量观察到<1%血浆浓度),表明CZP没有/极少从血浆转移到母乳。