How Safe IT Is to TREAT Pregnant FMF Patients with Anakinra ?

Huri Ozdogan¹, Serdal Ugurlu² and Bilgesu Ergezen¹, ¹Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical Faculty, University of Istanbul, Istanbul, Turkey, ²Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical Faculty, University of Istanbul, Turkey, Istanbul, Turkey

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Anakinra, familial Mediterranean fever and pregnancy

Session Information

Date: Sunday, November 8, 2015

Title: Miscellaneous Rheumatic and Inflammatory Diseases Poster I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: To assess the safety and efficacy of anakinra in pregnant FMF patients.

Methods: Six FMF patients, treated with anakinra during pregnancy were monitored for side effects, fetal and maternal outcomes.

Results: We present six FMF patients who were treated with Anakinra 100 mg/d sc during pregnancy due to severe protracted febrile myalgia in 4, thrombocytopenia in 1 and amyloidosis in 1. One of these patients has been previously reported (1). No anakinra-related adverse event was observed either in the mother-to-be or the fetus during pregnancy and delivery. One patient had an incision-site infection after c-section and one of the babies developed thrombocytopenia as his mother, and improved after treatment with IVIG. Four of these six patients gave birth to healthy babies and two are still pregnant . During the anakinra treatment, all patients recieved anakinra together with cholchicine, except one patient with thrombocytopenia was solely on Anakinra throughout pregnancy. No flare was observed in 3 out of 4 patients in whom Anakinra was was stopped after delivery. Pregnancy-related features are listed in Table 1.

Conclusion:

Anakinra promises to be a safe alternative in pregnant FMF patients who have active disease despite colchicine or intolerant and also can be given transiently during pregnancy and successfully stopped after delivery, as in our patients.

References:.

1) Lachman HJ, et al. Anti IL-1 therapies and pregnancy outcome. Pediatric Rheumatology 2013, 11 (Suppl 1) :A269

Table 1. Pregnancy-related outcomes

Case	Maternal Age	Anakinra Relation to pregnancy	USGs	Weeks at delivery or currrent gestational age	Gender of the baby/fetus	Mode of the delivery	1^stminute APGAR	Follow-up duration after birth (months)	Complications after birth
1	33	started at 21st GW and used continiously until birth	normal	Birth at 36^th GW	boy	C/S	8	34	No
2	28	started at 12th GW and used until birth	normal	Birth at 40^thGW	girl	vaginal	10	22	No
3	31	Conceived on Anakinra (have been on Anakinra since 2012), discontinued at 29th GW, reintroduced at 33^th GW due to symptom flare.	normal	Birth at 38^thGW	boy	C/S	6	4	Methicillin-Sensitive Staphylococcus Aureus incision-site infection (treated with Tygecycline) in mother
4	24	started at 15th GW and used until birth	normal	Birth at 38^th GW	boy	Vaginal	8	4	thrombocyte count of the baby was low (23,000/mm3) (After three courses of IVIG, it was increased to 95,000/mm3 and a month later to 269,000/mm3)
5	32	started at 16th GW, still using	normal	At 22^ndGW	Twin girls
6	25	Started at 23^th GW, still on Anakinra at 29^th GW	normal	At 29^th GW	girl

Disclosure: H. Ozdogan, None; S. Ugurlu, None; B. Ergezen, None.

To cite this abstract in AMA style:

Ozdogan H, Ugurlu S, Ergezen B. How Safe IT Is to TREAT Pregnant FMF Patients with Anakinra ? [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/how-safe-it-is-to-treat-pregnant-fmf-patients-with-anakinra/. Accessed .

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