Safety of anti-TNF agents during pregnancy and breastfeeding in women with inflammatory bowel disease

American Journal of Gastroenterology

Volumn 108, Issue 9, 2013, Pages 1426-1438

  Gisbert, Javier P ^a,b   Chaparro, María ^a,b  

^a Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas   (Spain)

^b INSTITUTO DE SALUD CARLOS III   (Spain)

Author keywords

[No Author keywords available]

Indexed keywords

ADALIMUMAB; AZATHIOPRINE; BALSALAZIDE; CORTICOSTEROID; CYCLOSPORIN; INFLIXIMAB; LIVE VACCINE; MERCAPTOPURINE; MESALAZINE; METHOTREXATE; METRONIDAZOLE; OLSALAZINE; SALAZOSULFAPYRIDINE; TACROLIMUS; THALIDOMIDE; TUMOR NECROSIS FACTOR INHIBITOR;

ABORTION; ADULT; ANTIBODY RESPONSE; ARTICLE; BREAST FEEDING; BREAST MILK; CONGENITAL MALFORMATION; CROHN DISEASE; DRUG SAFETY; ENTERITIS; FALLOT TETRALOGY; FEMALE; FIRST TRIMESTER PREGNANCY; FOLLOW UP; HUMAN; INTESTINE MALROTATION; INTRAUTERINE GROWTH RETARDATION; LOW BIRTH WEIGHT; MAINTENANCE THERAPY; MAJOR CLINICAL STUDY; MISSED ABORTION; NECROTIZING ENTEROCOLITIS; NEWBORN JAUNDICE; PATIENT SAFETY; PLACENTAL TRANSFER; PREGNANCY OUTCOME; PREGNANT WOMAN; PREMATURE LABOR; PRIORITY JOURNAL; RECOMMENDED DRUG DOSE; RHEUMATOID ARTHRITIS; SECOND TRIMESTER PREGNANCY; SPONTANEOUS ABORTION; STILLBIRTH; STRANGULATION; STRUCTURED QUESTIONNAIRE; THIRD TRIMESTER PREGNANCY; TRISOMY 18; VACCINATION;

ANTIBODIES, MONOCLONAL; BREAST FEEDING; FEMALE; HUMANS; IMMUNOGLOBULIN FAB FRAGMENTS; IMMUNOLOGIC FACTORS; INFLAMMATORY BOWEL DISEASES; PREGNANCY; TUMOR NECROSIS FACTOR-ALPHA;

EID: 84883743884     PISSN: 00029270     EISSN: 15720241     Source Type: Journal    
DOI: 10.1038/ajg.2013.171     Document Type: Article

References (123)

1. Moffatt DC , Bernstein CN. Drug therapy for Inflammatory bowel disease in pregnancy and the puerperium. Best Pract Res Clin Gastroenterol 2007 ; 21 : 835-47.
2. Mottet C , Juillerat P , Pittet V et al. Pregnancy and breastfeeding in patients with Crohn's disease. Digestion 2007 ; 76 : 149-60.
3. Gisbert JP , Gomollon F. Common errors in the management of outpatients with Inflammatory bowel disease. Gastroenterol Hepatol 2007 ; 30 : 469-86.
4. Habal FM , Ravindran NC. Management of Inflammatory bowel disease in the pregnant patient. World J Gastroenterol 2008 ; 14 : 1326-32.
5. Ferguson CB , Mahsud-Dornan S , Patterson RN. Inflammatory bowel disease in pregnancy. BMJ 2008 ; 337 : a427.
6. Habal FM , Kapila V. Inflammatory bowel disease and pregnancy: evidence, uncertainty and patient decision-making. Can J Gastroenterol 2009 ; 23 : 49-53.
7. Vermeire S , Carbonnel F , Coulie PG et al. Management of Inflammatory bowel disease in pregnancy. J Crohns Colitis 2012 ; 6 : 811-23.
8. Van Assche G , Dignass A , Reinisch W et al. The second European evidence-based Consensus on the diagnosis and management of Crohn's disease: special situations. J Crohns Colitis 2010 ; 4 : 63-101.
9. van der Woude CJ , Kolacek S , Dotan I et al. European evidenced-based consensus on reproduction in Inflammatory bowel disease. J Crohns Colitis 2010 ; 4 : 493-510.
10. Mahadevan U , Cucchiara S , Hyams JS et al. The London Position Statement of the World Congress of Gastroenterology on Biological Therapy for IBD with the European Crohn's and Colitis Organisation: pregnancy and pediatrics. Am J Gastroenterol 2011 ; 106 : 214-23 ; quiz 24.
11. Subhani JM , Hamiliton MI. Review article: the management of Inflammatory bowel disease during pregnancy. Aliment Pharmacol Ther 1998 ; 12 : 1039-53.
12. Connell W , Miller A. Treating Inflammatory bowel disease during pregnancy: risks and safety of drug therapy. Drug Saf 1999 ; 21 : 311-23.
13. Munkholm P. Pregnancy, fertility, and disease course in patients with Crohn's disease and ulcerative colitis. Eur J Intern Med 2000 ; 11 : 215-21.
14. Katz JA , Pore G. Inflammatory bowel disease and pregnancy. Infl amm Bowel Dis 2001 ; 7 : 146-57.
15. Alstead E. Fertility and pregnancy in Inflammatory bowel disease. World J Gastroenterol 2001 ; 7 : 455-9.
16. Alstead EM. Inflammatory bowel disease in pregnancy. Postgrad Med J 2002 ; 78 : 23-6.
17. Lamah M , Scott HJ. Inflammatory bowel disease and pregnancy. Int J Colorectal Dis 2002 ; 17 : 216-22.
18. Alstead EM , Nelson-Piercy C. Inflammatory bowel disease in pregnancy. Gut 2003 ; 52 : 159-61.
19. Kane S. Inflammatory bowel disease in pregnancy. Gastroenterol Clin North Am 2003 ; 32 : 323-40.
20. Steinlauf AF , Present DH. Medical management of the pregnant patient with Inflammatory bowel disease. Gastroenterol Clin North Am 2004 ; 33 : 361-85 , xi.
21. Ferrero S , Ragni N. Inflammatory bowel disease: management issues during pregnancy. Arch Gynecol Obstet 2004 ; 270 : 79-85.
22. Katz JA. Pregnancy and Inflammatory bowel disease. Curr Opin Gastroenterol 2004 ; 20 : 328-32.
23. Sauk J , Kane S. The use of medications for Inflammatory bowel disease during pregnancy and nursing. Expert Opin Pharmacother 2005 ; 6 : 1833-9.
24. Mahadevan U , Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology 2006 ; 131 : 283-311.
25. Cornish J , Tan E , Teare J et al. A meta-analysis on the infl uence of Inflammatory bowel disease on pregnancy. Gut 2007 ; 56 : 830-7.
26. Bortoli A , Pedersen N , Duricova D et al. Pregnancy outcome in Inflammatory bowel disease: prospective European case-control ECCO-EpiCom study, 2003-2006. Aliment Pharmacol Ther 2011 ; 34 : 724-34.
27. Kornfeld D , Cnattingius S , Ekbom A. Pregnancy outcomes in women with Inflammatory bowel disease-A population-based cohort study. Am J Obstet Gynecol 1997 ; 177 : 942-6.
28. Mahadevan U. Fertility and pregnancy in the patient with Inflammatory bowel disease. Gut 2006 ; 55 : 1198-206.
29. Hou JK , Mahadevan U. A 24-year-old pregnant woman with Inflammatory bowel disease. Clin Gastroenterol Hepatol 2009 ; 7 : 944-7.
30. Food Drug Administration. Regulations. 1980 ; 44 : 37434-67.
31. Hanauer SB , Feagan BG , Lichtenstein GR et al. Maintenance Infliximab for Crohn's disease: the ACCENT I randomised trial. Lancet 2002 ; 359 : 1541-9.
32. Rutgeerts P , Sandborn WJ , Feagan BG et al. Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med 2005 ; 353 : 2462-76.
33. Gisbert JP , Gonzalez-Lama Y , Mate J. Systematic review: Infliximab therapy in ulcerative colitis. Aliment Pharmacol Ther 2007 ; 25 : 19-37.
34. Sandborn WJ , Hanauer SB , Rutgeerts P et al. Adalimumab for maintenance treatment of Crohn's disease: results of the CLASSIC II trial. Gut 2007 ; 56 : 1232-9.
35. Hanauer SB , Sandborn WJ , Rutgeerts P et al. Human anti-tumor necrosis factor monoclonal antibody (adalimumab) in Crohn's disease: the CLASSIC-I trial. Gastroenterology 2006 ; 130 : 323-33 ; quiz 591.
36. Reinisch W , Sandborn WJ , Hommes DW et al. Adalimumab for induction of clinical remission in moderately to severely active ulcerative colitis: results of a randomised controlled trial. Gut 2011 ; 60 : 780-7.
37. Sandborn WJ , van Assche G , Reinisch W et al. Adalimumab induces and maintains clinical remission in patients with moderate-to-severe ulcerative colitis. Gastroenterology 2012 ; 142 : 257-65 , e1-3.
38. Schreiber S , Khaliq-Kareemi M , Lawrance IC et al. Maintenance therapy with certolizumab pegol for Crohn's disease. N Engl J Med 2007 ; 357 : 239-50.
39. Gisbert JP. Safety of immunomodulators and biologics for the treatment of Inflammatory bowel disease during pregnancy and breast-feeding. Infl amm Bowel Dis 2010 ; 16 : 881-95.
40. Chaparro M , Gisbert JP. Transplacental transfer of immunosuppressants and biologics used for the treatment of Inflammatory bowel disease. Curr Pharm Biotechnol 2011 ; 12 : 765-73.
41. Chambers CD , Johnson DL. Emerging data on the use of anti-tumor necrosis factor-alpha medications in pregnancy. Birth Defects Res A Clin Mol Teratol 2012 ; 94 : 607-11.
42. Saji F , Samejima Y , Kamiura S et al. Dynamics of immunoglobulins at the feto-maternal interface. Rev Reprod 1999 ; 4 : 81-9.
43. Simister NE. Placental transport of immunoglobulin G. Vaccine 2003 ; 21 : 3365-9.
44. Takizawa T , Anderson CL , Robinson JM. A novel Fc gamma R-defi ned, IgG-containing organelle in placental endothelium. J Immunol 2005 ; 175 : 2331-9.
45. Pentsuk N , van der Laan JW. An interspecies comparison of placental antibody transfer: new insights into developmental toxicity testing of monoclonal antibodies. Birth Defects Res B Dev Reprod Toxicol 2009 ; 86 : 328-44.
46. Malek A. Ex vivo human placenta models: transport of immunoglobulin G and its subclasses. Vaccine 2003 ; 21 : 3362-4.
47. Story CM , Mikulska JE , Simister NE. A major histocompatibility complex class I-like Fc receptor cloned from human placenta: possible role in transfer of immunoglobulin G from mother to fetus. J Exp Med 1994 ; 180 : 2377-81.
48. Roopenian DC , Akilesh S. FcRn: the neonatal Fc receptor comes of age. Nat Rev Immunol 2007 ; 7 : 715-25.
49. Israel EJ , Simister N , Freiberg E et al. Immunoglobulin G binding sites on the human foetal intestine: a possible mechanism for the passive transfer of immunity from mother to infant. Immunology 1993 ; 79 : 77-81.
50. Bright NA , Ockleford CD. Cytotrophoblast cells: a barrier to maternofetal transmission of passive immunity. J Histochem Cytochem 1995 ; 43 : 933-44.
51. Gurevich P , Elhayany A , Ben-Hur H et al. An immunohistochemical study of the secretory immune system in human fetal membranes and decidua of the fi rst trimester of pregnancy. Am J Reprod Immunol 2003 ; 50 : 13-9.
52. Mahadevan U. Certolizumab use in pregnancy: low levels detected in cord blood. Gastroenterology 2009 ; 136 : A960.
53. Toder V , Fein A , Carp H et al. TNF-alpha in pregnancy loss and embryo maldevelopment: a mediator of detrimental stimuli or a protector of the fetoplacental unit? J Assist Reprod Genet 2003 ; 20 : 73-81.
54. Rychly DJ , DiPiro JT. Infections associated with tumor necrosis factor-alpha antagonists. Pharmacotherapy 2005 ; 25 : 1181-92.
55. Baker DE. Adalimumab: human recombinant immunoglobulin g1 antitumor necrosis factor monoclonal antibody. Rev Gastroenterol Disord 2004 ; 4 : 196-210.
56. Stephens P , Nesbitt A , Foulkes R. Placental transfer of the anti-TNF antibody TN3 in rats: comparison of immunoglobulin G1 and pegylated Fab versions. Gut 2006 ; 55 (Suppl.) : A8.
57. Nesbitt ABDSS , Foulkes R. Placental transfer and accumulation in milk of the anti-TNF antibody TN3 in rats: immunoglobulin G1 versus PEGylated Fab. Am J Gastroenterol 2006 ; 101 : S438.
58. Raghupathy R. Th 1-type immunity is incompatible with successful pregnancy. Immunol Today 1997 ; 18 : 478-82.
59. Clark DA. Should anti-TNF-alpha therapy be off ered to patients with infertility and recurrent spontaneous abortion? Am J Reprod Immunol 2009 ; 61 : 107-12.
60. Winger EE , Reed JL , Ashoush S et al. Treatment with adalimumab (Humira) and intravenous immunoglobulin improves pregnancy rates in women undergoing IVF. Am J Reprod Immunol 2009 ; 61 : 113-20.
61. Winger EE , Reed JL. Treatment with tumor necrosis factor inhibitors and intravenous immunoglobulin improves live birth rates in women with recurrent spontaneous abortion. Am J Reprod Immunol 2008 ; 60 : 8-16.
62. Hyrich KL , Symmons DP , Watson KD et al. Pregnancy outcome in women who were exposed to anti-tumor necrosis factor agents: results from a national population register. Arthritis Rheum 2006 ; 54 : 2701-2.
63. Verstappen SM , King Y , Watson KD et al. Anti-TNF therapies and pregnancy: outcome of 130 pregnancies in the British Society for Rheumatology Biologics Register. Ann Rheum Dis 2011 ; 70 : 823-6.
64. Carter JD , Ladhani A , Ricca LR et al. A safety assessment of tumor necrosis factor antagonists during pregnancy: a review of the Food and Drug Administration database. J Rheumatol 2009 ; 36 : 635-41.
65. Winger EE , Reed JL. Was risk properly assessed in Carter, et al 's safety assessment of tumor necrosis factor antagonists during pregnancy? J Rheumatol 2009 ; 36 : 2122 ; author reply 3.
66. Koren G , Inoue M. Do tumor necrosis factor inhibitors cause malformations in humans? J Rheumatol 2009 ; 36 : 465-6.
67. Schnitzler F , Fidder H , Ferrante M et al. Outcome of pregnancy in women with Inflammatory bowel disease treated with antitumor necrosis factor therapy. Infl amm Bowel Dis 2011 ; 17 : 1846-54.
68. Vinet E , Pineau C , Gordon C et al. Biologic therapy and pregnancy outcomes in women with rheumatic diseases. Arthritis Rheum 2009 ; 61 : 587-92.
69. Johnson DL , Jones KL , Chambers CD et al. Pregnancy outcomes in women exposed to adalimumab: the OTIS autoimmune diseases in pregnancy project. Gastroenterology 2009 ; 136 : A-27.
70. Roux CH , Brocq O , Breuil V et al. Pregnancy in rheumatology patients exposed to anti-tumour necrosis factor (TNF)-alpha therapy. Rheumatology (Oxford) 2007 ; 46 : 695-8.
71. Berthelot JM , De Bandt M , Goupille P et al. Exposition to anti-TNF drugs during pregnancy: outcome of 15 cases and review of the literature. Joint Bone Spine 2009 ; 76 : 28-34.
72. Jurgens M , Brand S , Filik L et al. Safety of adalimumab in Crohn's disease during pregnancy: case report and review of the literature. Infl amm Bowel Dis 2010 ; 16 : 1634-6.
73. Ostensen M , Brucato A , Carp H et al. Pregnancy and reproduction in autoimmune rheumatic diseases. Rheumatology (Oxford) 2011 ; 50 : 657-64.
74. Marchioni RM , Blonski W , Lichtenstein GR. TNF-alpha inhibitor therapy and fetal risk: a systematic literature review. Gastroenterology 2012 ; 142 (Suppl. 1) : S248-9.
75. Srinivasan R. Infliximab treatment and pregnancy outcome in active Crohn's disease. Am J Gastroenterol 2001 ; 96 : 2274-5.
76. Lichtenstein GR , Feagan BG , Cohen RD et al. Serious infections and mortality in association with therapies for Crohn's disease: TREAT registry. Clin Gastroenterol Hepatol 2006 ; 4 : 621-30.
77. Katz JA , Antoni C , Keenan GF et al. Outcome of pregnancy in women receiving Infliximab for the treatment of Crohn's disease and rheumatoid arthritis. Am J Gastroenterol 2004 ; 99 : 2385-92.
78. Lichtenstein GR , Feagan BG , Cohen RD et al. Serious infection and mortality in patients with Crohn's disease: more than 5 years of follow-up in the TREAT registry. Am J Gastroenterol 2012 ; 107 : 1409-22.
79. Mahadevan U , Kane S , Sandborn WJ et al. Intentional Infliximab use during pregnancy for induction or maintenance of remission in Crohn's disease. Aliment Pharmacol Ther 2005 ; 21 : 733-8.
80. Correia LM , Bonilha DQ , Ramos JD et al. Inflammatory bowel disease and pregnancy: report of two cases treated with Infliximab and a review of the literature. Eur J Gastroenterol Hepatol 2010 ; 22 : 1260-4.
81. O ' Donnell S , O ' Morain C. Review article: use of antitumour necrosis factor therapy in Inflammatory bowel disease during pregnancy and conception. Aliment Pharmacol Ther 2008 ; 27 : 885-94.
82. Vesga L , Terdiman JP , Mahadevan U. Adalimumab use in pregnancy. Gut 2005 ; 54 : 890.
83. Mishkin DS , Van Deinse W , Becker JM et al. Successful use of adalimumab (Humira) for Crohn's disease in pregnancy. Infl amm Bowel Dis 2006 ; 12 : 827-8.
84. Coburn LA , Wise PE , Schwartz DA. The successful use of adalimumab to treat active Crohn's disease of an ileoanal pouch during pregnancy. Dig Dis Sci 2006 ; 51 : 2045-7.
85. Oussalah A , Bigard MA , Peyrin-Biroulet L. Certolizumab use in pregnancy. Gut 2009 ; 58 : 608.
86. Burt MJ , Frizelle FA , Barbezat GO. Pregnancy and exposure to Infliximab (anti-tumor necrosis factor-alpha monoclonal antibody). J Gastroenterol Hepatol 2003 ; 18 : 465-6.
87. Vasiliauskas EA , Church JA , Silverman N et al. Case report: evidence for transplacental transfer of maternally administered Infliximab to the newborn. Clin Gastroenterol Hepatol 2006 ; 4 : 1255-8.
88. Tursi A. Effect of intentional Infliximab use throughout pregnancy in inducing and maintaining remission in Crohn's disease. Dig Liver Dis 2006 ; 38 : 439-40.
89. Stengel JZ , Arnold HL. Is Infliximab safe to use while breastfeeding? World J Gastroenterol 2008 ; 14 : 3085-7.
90. Angelucci E , Cocco A , Viscido A et al. Safe use of Infliximab for the treatment of fi stulizing Crohn's disease during pregnancy within 3 months of conception. Infl amm Bowel Dis 2008 ; 14 : 435-6.
91. Kane S , Ford J , Cohen R et al. Absence of Infliximab in infants and breast milk from nursing mothers receiving therapy for Crohn's disease before and after delivery. J Clin Gastroenterol 2009 ; 43 : 613-6.
92. Aratari A , Margagnoni G , Koch M et al. Intentional Infliximab use during pregnancy for severe steroid-refractory ulcerative colitis. J Crohns Colitis 2011 ; 5 : 262.
93. Zelinkova Z , de Haar C , de Ridder L et al. High intra-uterine exposure to Infliximab following maternal anti-TNF treatment during pregnancy. Aliment Pharmacol Ther 2011 ; 33 : 1053-8.
94. Machkova N , Bortlik M , Duricova D et al. Pregnancy and newborn outcome of mothers with Inflammatory bowel disease exposed to anti-TNFα therapy during pregnancy: three-centre study. J Crohns Colitis 2012 ; 6 (suppl. 1) : P370.
95. Mahadevan U , Martin CF , Sandler RS et al. PIANO: a 1000 patient prospective registry of pregnancy outcomes in women with IBD exposed to immunomodulators and biologic therapy. Gastroenterology 2012 ; 142 (Suppl. 1) : S149.
96. Casanova MJ , Chaparro M , Domenech E et al. Safety of thiopurines and anti-TNF-alpha drugs during pregnancy in patients with Inflammatory bowel disease. Am J Gastroenterol 2013 ; 108 : 433-40.
97. March of Dimes Birth Defects Foundation. Fact Sheets: Birth Defects, Miscarriage, and Stillbirth; Leading Categories of Birth Defects; and Perinatal Profi les: Statistics for Monitoring State Maternal and Infant Health. 2001. http://www.modimes.org.
98. Djokanovic N , Klieger-Grossmann C , Pupco A et al. Safety of Infliximab use during pregnancy. Reprod Toxicol 2011 ; 32 : 93-7.
99. Mahadevan U , Terdiman JP , Church J. Infliximab levels in infants born to women with Inflammatory bowel disease. Gastroenterology 2007 ; 132 : A144.
100. Steenholdt C , Al-Khalaf M , Ainsworth MA et al. Therapeutic Infliximab drug level in a child born to a woman with ulcerative colitis treated until gestation week 31. J Crohns Colitis 2012 ; 6 : 358-61.
101. Roopenian DC , Christianson GJ , Sproule TJ et al. The MHC class I-like IgG receptor controls perinatal IgG transport, IgG homeostasis, and fate of IgG-Fc-coupled drugs. J Immunol 2003 ; 170 : 3528-33.
102. Mahadevan U , Wolf DC , Dubinsky M et al. Placental transfer of antitumor necrosis factor agents in pregnant patients with Inflammatory bowel disease. Clin Gastroenterol Hepatol 2013 ; 11 : 286-92 ; quiz e24.
103. Arsenescu R , Arsenescu V , de Villiers WJ. TNF-alpha and the development of the neonatal immune system: implications for inhibitor use in pregnancy. Am J Gastroenterol 2011 ; 106 : 559-62.
104. Cheent K , Nolan J , Shariq S et al. Case Report: fatal case of disseminated BCG infection in an infant born to a mother taking Infliximab for Crohn's disease. J Crohns Colitis 2010 ; 4 : 603-5.
105. Vasiliauskas ED , Barry M , Dubinsky M. High serum levels of Infliximab detected in the newborn of a mother receiving during pregnancy. Gastroenterology 2005 ; 128 : P33.
106. Louis E , Mary JY , Vernier-Massouille G et al. Maintenance of remission among patients with Crohn's disease on antimetabolite therapy after infliximab therapy is stopped. Gastroenterology 2012 ; 142 : 63-70 e5; quiz e31.
107. Domenech E , Hinojosa J , Nos P et al. Clinical evolution of luminal and perianal Crohn's disease after inducing remission with Infliximab: how long should patients be treated? Aliment Pharmacol Ther 2005 ; 22 : 1107-13.
108. Friedman S , Regueiro MD. Pregnancy and nursing in Inflammatory bowel disease. Gastroenterol Clin North Am 2002 ; 31 : 265-73 , xii.
109. Habal FM , Huang VW. Review article: a decision-making algorithm for the management of pregnancy in the Inflammatory bowel disease patient. Aliment Pharmacol Ther 2012 ; 35 : 501-15.
110. Oussalah A , Roblin X , Laharie D et al. Tumour necrosis factor antagonists and Inflammatory bowel diseases: a national practice survey. Aliment Pharmacol Ther 2009 ; 30 : 854-63.
111. Ternant D , Aubourg A , Magdelaine-Beuzelin C et al. Infliximab pharmacokinetics in Inflammatory bowel disease patients. Ther Drug Monit 2008 ; 30 : 523-9.
112. Zelinkova Z , van der Ent C , Bruin KF et al. Effects of discontinuing anti-tumor necrosis factor therapy during pregnancy on the course of Inflammatory bowel disease and neonatal exposure. Clin Gastroenterol Hepatol 2013 ; 11 : 318-21.
113. Zelinkova Z , Van der Ent C , Kuipers E et al. Prospective assessment of the adalimumab discontinuation during pregnancy in Inflammatory bowel disease patients. Gastroenterology 2012 ; 142 (suppl. 1) : S385-6.
114. Gartner LM , Morton J , Lawrence RA et al. Breastfeeding and the use of human milk. Pediatrics 2005 ; 115 : 496-506.
115. Kane S , Lemieux N. The role of breastfeeding in postpartum disease activity in women with Inflammatory bowel disease. Am J Gastroenterol 2005 ; 100 : 102-5.
116. Van de Perre P. Transfer of antibody via mother's milk. Vaccine 2003 ; 21 : 3374-6.
117. Peltier M , James D , Ford J. Infliximab levels in breast-milk of a nursing Crohn's patient. Am J Gastroenterol 2001 ; 96 : P258.
118. Ben-Horin S , Yavzori M , Kopylov U et al. Detection of Infliximab in breast milk of nursing mothers with Inflammatory bowel disease. J Crohns Colitis 2011 ; 5 : 555-8.
119. Ben-Horin S , Yavzori M , Katz L et al. Adalimumab level in breast milk of a nursing mother. Clin Gastroenterol Hepatol 2010 ; 8 : 475-6.
120. Fritzsche J , Pilch A , Mury D et al. Infliximab and adalimumab use during breastfeeding. J Clin Gastroenterol 2012 ; 46 : 718-9.
121. Israel EJ , Taylor S , Wu Z et al. Expression of the neonatal Fc receptor, FcRn, on human intestinal epithelial cells. Immunology 1997 ; 92 : 69-74.
122. Shah U , Dickinson BL , Blumberg RS et al. Distribution of the IgG Fc receptor, FcRn, in the human fetal intestine. Pediatr Res 2003 ; 53 : 295-301.
123. Ben-Horin S , Avidan B , Yanai H et al. Familial clustering of Crohn's disease in Israel: prevalence and association with disease severity. Infl amm Bowel Dis 2009 ; 15 : 171-5.