Monoclonal Antibodies (Biologics) for Allergic Rhinitis, Asthma, and Atopic Dermatitis During Pregnancy and Lactation

Immunol Allergy Clin North Am. 2023 Feb;43(1):187-197. doi: 10.1016/j.iac.2022.07.001.

Abstract

Asthma, allergic rhinitis, chronic urticaria, and atopic dermatitis are common diseases that affect hundreds of thousands of pregnant women each year. The authors discuss the use of biologics in women who are pregnant or lactating, indications, available safety information, and knowledge gaps. There are pregnant patients for which standard treatment is either inadequate or contraindicated; in those cases, monoclonal antibodies (biologics) should be considered despite the unknown risk to the fetus. In severe asthma, omalizumab is the best studied with reassuring available safety data. Insufficient safety data exist on mepolizumab, reslizumab, benralizumab, dupilumab, and tezepelumab use during pregnancy and lactation.

Keywords: Allergic rhinitis; Asthma; Biologics and safety; Eczema; Lactation; Mother to baby; Pregnancy; Vaccines and medications during pregnancy surveillance studies.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Asthma* / drug therapy
  • Biological Products* / therapeutic use
  • Dermatitis, Atopic* / drug therapy
  • Female
  • Humans
  • Lactation
  • Pregnancy
  • Rhinitis, Allergic*

Substances

  • Antibodies, Monoclonal
  • Biological Products