Pregnancy Outcomes in Women With Psoriasis Exposed to Biologic vs Nonbiologic Therapies

Pregnancy outcomes for women with moderate to severe psoriasis exposed to biologic agents appear similar to women with psoriasis exposed to nonbiologic agents, study data published in JAMA Dermatology suggests.

The study relied on data from the multicenter, observational Psoriasis Longitudinal Assessment and Registry (PSOLAR), which evaluated the long-term safety and outcomes of patients with psoriasis who received biologic agents and/or conventional systemic treatments. A total of 2224 women of childbearing age (mean age, 27.8 years) with a total of 12,929 patient-years of follow-up (median age, 7.2 years) were included in this analysis of the PSOLAR.

Primary outcome measures included exposure to biologic agents at any time or either 1 year or less before birth or 6 months or less before spontaneous abortion. Self-reported pregnancy-related outcomes, including births, stillbirths, spontaneous abortions, and elective terminations, were assessed.

Of 298 pregnancies, approximately 81.9% resulted in birth, 13.8% ended in spontaneous abortion, and 4.4% were electively terminated. Approximately 90.9% of 243 births were full term, and 9.1% of infants were born prematurely. There were 231 healthy newborns, 10 infants with a neonatal condition, 2 infants with a congenital anomaly, and 1 stillbirth.

A total of 252 pregnancies had biologic agent exposure either before or during pregnancy, including 56.4% of pregnancies exposed to these therapies during the prenatal period. There were no proportional differences between the pregnancies exposed and not exposed to biologic agents in terms of birth outcomes, including healthy newborns, congenital anomalies, neonatal adverse events, and stillbirths.

A limitation of the PSOLAR used in this study was the inclusion of medical history only at baseline, which the investigators suggest may have limited the collection of relevant details regarding fertility and pregnancy outcomes.

In spite of these limitations, the researchers suggest that their findings indicate “pregnancy outcomes among women with moderate-to-severe psoriasis in PSOLAR have remained consistent with previously reported data and the general population.”

Disclosure: This clinical trial was supported by Janssen. Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Kimball AB, Guenther L, Kalia S, et al. Pregnancy outcomes in women with moderate-to-severe psoriasis from the psoriasis longitudinal assessment and registry (PSOLAR). Published online February 3, 2021. JAMA Dermatol. doi:10.1001/jamadermatol.2020.5595