M. Vu, C. Dolianitis, A. Braue, G. Varigos, J. Nicolopoulos
Chronic plaque psoriasis (CPP) commonly affects women during their reproductive years. Management of CPP during pregnancy is challenging given the unpredictable disease course and limited treatment options. Whilst targeted biologic therapies have proved effective for CPP, there is inadequate pregnancy safety data. Ustekinumab is an IL12/ 23 inhibitor that is a common treatment option for patients with CPP. Ustekinumab is an Australian Drug Evaluation Committee (ADEC) pregnancy category B1 medication with post marketing pregnancy safety data limited to eleven published case reports in CPP. We present a case series of six pregnancies with maternal exposure to ustekinumab for the treatment of CPP. There were six live births of healthy full term infants with no reported adverse foetal outcomes. We also review the literature and describe the outcomes of 498 pregnancies from the Janssen clinical trials database, which reports 9 congenital anomalies and 51 spontaneous abortions. The new data adds to the growing literature on maternal exposure to ustekinumab during pregnancy however further experience is needed before safety can be confidently established.