The use and impact of monoclonal antibody biologics during pregnancy

Monoclonal antibody biologics, also known as biologics, have revolutionized the treatment and quality of life of many patients with inflammatory and autoimmune conditions. 1 Women of reproductive age are increasingly using these agents to maintain disease remission because of emerging evidence of safety before conception, during pregnancy and lactation.

Biologic drugs contain an immunoglobulin G (IgG) structure. They bind to receptors or key inflammatory molecules and may modulate inflammation by inhibiting cytokine production, lymphocyte trafficking, costimulation signal blockade or B-cell depletion. The use of biologics has become standard treatment for many conditions, including inflammatory bowel disease (IBD), systemic lupus erythematosus, multiple sclerosis, rheumatoid arthritis and psoriasis, for which they have revolutionized clinical care. More biologics with broader indications are now available for clinical use, making it challenging to keep up with each drug’s characteristics and effects on the immune system.