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Answers tagged TNF antagonists: Page 1 of 1

Linden from Montreal asks: My wife suffers from rheumatoid arthritis. She normally takes etanercept injections to mitigate the symptoms of her arthritis. She is now breastfeeding and has stopped taking the injections for some time. Her inflammation and pain are getting worse, and we are wondering if it is safe to use etanercept during breastfeeding.

There is limited data about the safety of entanercept or any of the other TNF antagonists during pregnancy and breastfeeding.   From the available data, there is no clear indication that TNF antagonists are problematic in pregnancy and breastfeeding.  As rheumatoid arthritis goes into remission for many women, and with some uncertainty of safety still present, most women will stop TNF blockers when they know they are pregnant.  That said, there are many women who have had successful pregnancies while using TNF antagonists.

For breastfeeding, officially, it is not recommended by the pharmaceutical manufacturers of these medications.  However, there is no data to suggest it is harmful to the baby.  There is a very small amount of TNF antagonist that is excreted in mother’s milk; it is thought, though, that the medication is broken down in the baby’s gut and therefore is likely not harmful.  Ultimately, each individual must balance this small unknown risk and the functional abilities of the mother to care for their newborn if they have active inflammatory arthritis.


Carolina from Calgary asks: My husband has AS and may be starting a TNF blocker. We were told once he starts it, he will be on it for life, even if he goes into complete remission because the worst thing to do with biologics is to start and stop them since it may increase immunity to it. So, if after a while he is free of symptoms, can he to try to wean off the med or does he have to take it for the rest of his life?

Assuming a good response to a biologic for ankylosing spondylitis or rheumatoid arthritis, one can always try to see if the disease will remain under control off medication, be it a biologic or traditional DMARD. There is a risk of the disease flaring of course, and there is a risk of not having as a good a response to the same medications a second time. However, many patients do this and most do not have problems restarting their medications again.

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