Pregnancy outcomes in patients with PsO receiving biologics

Results from a large, retrospective cohort study comparing adverse pregnancy outcomes (APOs) between biologic-exposed (n = 1,226) and unexposed (n = 1,238) female patients with psoriasis (PsO) were published in the Journal of the American Academy of Dermatology by Bar et al. The primary outcomes were APOs, including spontaneous abortion, stillbirth or intrauterine fetal death, preterm birth before 37 weeks’ gestation, small for gestational age, low birth weight (≤2,500 g), preeclampsia and eclampsia, gestational hypertension, and gestational diabetes mellitus (GDM). 

Key data: Any APO occurred significantly less frequently in biologic-exposed patients vs unexposed controls (24.1% vs 30.0%; odds ratio [OR], 0.76; 95% confidence interval [CI], 0.64–0.89; p = 0.0013). Biologic exposure was associated with lower odds of spontaneous abortion (8.40% vs 10.90%; OR, 0.75; 95% CI, 0.57–0.98; p = 0.0406) and GDM (4.16% vs 7.43%; OR, 0.54; 95% CI, 0.38–0.77; p = 0.00054), while rates of all other APOs were similar between groups. APO rates were comparable across biologic classes (p = 0.31) and neonatal outcomes were broadly similar between groups. 

Key learning: Biologic therapy in female patients with PsO was not associated with increased risk of APOs compared with unexposed controls, suggesting that adequate disease control during pregnancy may reduce obstetric risk.