Nardin Charlée, Colas Morgane, Curie Vincent, Pelletier Fabien, Puzenat Eve, Aubin François
Service de Dermatologie, Centre Hospitalier Universitaire, Université de Franche Comté, Unité de recherche EA 3181, Besançon, France.
Service de Gynécologie, Centre Hospitalier, Dole, France.
Dermatol Ther (Heidelb). 2018 Jun;8(2):323-326. doi: 10.1007/s13555-018-0232-7. Epub 2018 Mar 9.
Little is known about whether immunosuppressed patients mount the immunological response necessary to ensure tubal occlusion. Theoretical concern for non-occlusion has limited the use of hysteroscopic sterilization in patients on immunosuppressive therapies. The effects of tumor necrosis factor-alpha (TNF-α) blockers and interleukin (IL)-17 inhibitors on contraception and pregnancy for patients with psoriasis are poorly documented. We report a case of pregnancy that ended in miscarriage in a patient treated first with TNF-α and then with IL-17 inhibitors for severe psoriasis after tubal sterilization with micro-inserts. Our observation suggests that the efficacy of tubal sterilization by micro-inserts may be impaired by these two biologics and that the risk of miscarriage may be increased in women with psoriasis treated with secukinumab.
关于免疫抑制患者是否能产生确保输卵管闭塞所需的免疫反应，我们所知甚少。对未闭塞的理论担忧限制了免疫抑制治疗患者宫腔镜绝育术的应用。肿瘤坏死因子-α（TNF-α）阻滞剂和白细胞介素（IL）-17抑制剂对银屑病患者避孕和妊娠的影响鲜有文献记载。我们报告了一例妊娠病例，该患者在使用微型插入物进行输卵管绝育术后，先接受TNF-α治疗，后接受IL-17抑制剂治疗严重银屑病，最终以流产告终。我们的观察表明，这两种生物制剂可能会损害微型插入物输卵管绝育术的疗效，并且接受司库奇尤单抗治疗的银屑病女性流产风险可能会增加。
