Fotiadou Christina, Lazaridou Elizabeth, Sotiriou Eleni, Ioannides Demetrios
First Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece.
J Dermatol Case Rep. 2012 Dec 31;6(4):105-7. doi: 10.3315/jdcr.2012.1116.
Psoriasis affects a considerable proportion of women in their reproductive years. Limited published data exist about the possible negative impact of the disease itself in the prognosis of pregnancy. On this background, the emergence of newer biologic agents for psoriasis treatment - such as ustekinumab - raises safety issues concerning the exposure to the drug during pregnancy. To our knowledge this is the first report in the literature describing a pregnancy outcome under ustekinumab treatment.
We report a 35-year-old female psoriasis patient who was under treatment with ustekinumab for a year when she inadvertedly became pregnant. The drug was discontinued immediately and the patient did not opt for termination. During the 12th week of gestation she experienced a spontaneous abortion.
Although the patient's profile fulfilled 2 general risk factors for spontaneous abortion - she was a smoker and this was her third pregnancy - one could not underestimate the possible role of the drug and of psoriasis per se in this adverse pregnancy outcome. Pregnancy registries and large prospective studies are needed in order to determine whether poorer pregnancies outcomes in psoriatic women are due to the disease itself, associated comorbidities or side-effects of new therapies such as ustekinumab.
银屑病影响着相当一部分处于生育年龄的女性。关于该疾病本身对妊娠预后可能产生的负面影响，已发表的数据有限。在此背景下，用于治疗银屑病的新型生物制剂（如优特克单抗）的出现引发了关于孕期接触该药物的安全性问题。据我们所知，这是文献中首篇描述优特克单抗治疗期间妊娠结局的报告。
我们报告一名35岁的女性银屑病患者，她在接受优特克单抗治疗一年后意外怀孕。药物立即停用，患者未选择终止妊娠。在妊娠第12周时，她发生了自然流产。
尽管该患者的情况符合自然流产的两个一般风险因素——她是吸烟者且这是她的第三次妊娠——但不能低估药物本身以及银屑病在这一不良妊娠结局中可能发挥的作用。需要建立妊娠登记系统并开展大型前瞻性研究，以确定银屑病女性较差的妊娠结局是由于疾病本身、相关合并症还是诸如优特克单抗等新疗法的副作用。
