Nakai Takehiro, Ikeda Yukihiko, Yamaguchi Kenichi, Asano Takahiro, Iwata Futoshi, Kidoguchi Genki, Fukui Sho, Ozawa Hiroki, Kawaai Satoshi, Kitada Ayako, Suda Masei, Nomura Atsushi, Tamaki Hiromichi, Okada Masato
Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo 104-8560, Japan.
Center for Clinical Epidemiology, St. Luke's International University, Tokyo, Japan.
Mod Rheumatol Case Rep. 2023 Jan 3;7(1):82-86. doi: 10.1093/mrcr/rxac069.
Since its approval for the management of systemic lupus erythematosus (SLE), belimumab has been widely used. However, its pregnancy safety profile has been underinvestigated. We present the pregnancy outcomes of two cases of early placental exposure to belimumab and summarise the pregnancy outcomes in previous reports regarding placental exposure to belimumab. Case 1 describes a 27-year-old woman with an 18-year history of SLE and lupus nephritis class III. We introduced belimumab 19 months prior to conception to control her proteinuria and discontinued its use at 5 weeks and 5 days of gestation. Her lupus activity was stable throughout pregnancy, and at 37 weeks and 1 day of gestation, she delivered a healthy girl with no anomaly. At delivery, the girl was small for gestational age, but at the 1-year follow-up, there was no delay in her growth or any serious infection. Case 2 describes a 32-year-old woman with a 15-year history of SLE. We introduced belimumab 9 months prior to conception and discontinued its use at 7 weeks and 1 day of gestation. Although her lupus was well controlled without belimumab, a missed abortion occurred, which was possibly due to foetal factors. Although there is accumulating data on the safety of belimumab use during pregnancy, it seems necessary to cautiously use this medication in pregnant women, until further analyses are conducted.
自被批准用于治疗系统性红斑狼疮（SLE）以来，贝利尤单抗已被广泛使用。然而，其在孕期的安全性研究不足。我们报告了两例早期胎盘暴露于贝利尤单抗的妊娠结局，并总结了既往关于胎盘暴露于贝利尤单抗的妊娠结局报告。病例1为一名27岁女性，有18年SLE病史及III级狼疮性肾炎。我们在其受孕前19个月引入贝利尤单抗以控制蛋白尿，并在妊娠5周零5天时停用。她在整个孕期狼疮活动稳定，在妊娠37周零1天时，她分娩了一名健康女婴，无异常。分娩时，女婴小于孕周，但在1年随访时，其生长无延迟，也无任何严重感染。病例2为一名32岁女性，有15年SLE病史。我们在其受孕前9个月引入贝利尤单抗，并在妊娠7周零1天时停用。尽管在未使用贝利尤单抗的情况下其狼疮得到良好控制，但发生了稽留流产，这可能是由于胎儿因素。尽管关于孕期使用贝利尤单抗的安全性数据不断积累，但在进行进一步分析之前，在孕妇中谨慎使用这种药物似乎是必要的。
