Dermatol. praxi. 2019;13(2):63-67 | DOI: 10.36290/der.2019.022

Pregnancy, maternity and plaque psoriasis

MUDr. Filip Rob, Ph.D.

Dermatovenerologická klinika 2. LF UK a Nemocnice Na Bulovce, Praha

Pregnancy is an immunologically very specific period in which numerous immunomodulatory changes occur allowing growth of the fetus in the mother‘s body. These changes affect the course of psoriasis and may make psoriasis worse. Moreover psoriasis itself as a systemic inflammation affects the course of pregnancy, especially in women with serious disease the effect may be negative. Because the most commonly used systemic drugs are contraindicated in pregnancy and clinical trials cannot be performed on pregnant women, lack of experience with efficacy and safety of mainly new biological drugs complicates treatment decisions. Thus, treatment of pregnant patients with psoriasis may be a major challenge. Many women do not start the treatment of severe psoriasis because they are afraid of the treatment adverse effects. However, in the last decade, knowledge on the safety of biological drugs in pregnancy has increased considerably, it seems that biologic treatment in the first two trimesters is safe for both mother and fetus. Recently, certolizumab pegol has been approved for the treatment of psoriasis with already relatively large data on the safety in pregnancy and breastfeeding. Certolizumab almost does not cross the placental barrier or into breast milk, so it is a suitable treatment for pregnant patients with psoriasis or women planning pregnancy.

Keywords: psoriasis, pregnancy, breastfeeding, biologic therapy, certolizumab pegol.

Received: November 18, 2018; Accepted: January 6, 2019; Published: June 10, 2019  Show citation