Patterns of Use and Discontinuation for Tumor Necrosis Factor Inhibitors in Pregnant Women: Insights From a Real-World Sample
Authors' conclusion
We observed trends toward increased continuous TNFi use throughout gestation (and fewer corticosteroids in this group), suggesting growing confidence in the safety and effectiveness of TNFi use in pregnancy.
Study context
- Population
- Pregnancies resulting in a live birth among women aged 15–45 years with rheumatoid arthritis (RA), radiographic axial spondyloarthritis (r-axSpA), psoriatic arthritis (PsA), psoriasis (PsO) and/or inflammatory bowel diseases (IBD) hospitalized for delivery, January 2011–December 2021, MarketScan commercial claims database
- Participants
- 3,711 tumor necrosis factor inhibitor (TNFi)-exposed pregnancies
- Exposure
- TNFi discontinuation at specific gestational timepoints vs continuation throughout gestation
- Outcome
- TNFi usage patterns in pregnancy
Methodological detailsclaims database (MarketScan commercial)
- Claims database (MarketScan commercial)
Main finding
As reported in the abstract
TNFi usage patterns in TNFi-exposed pregnancies
- Continuous TNFi use throughout all 3 trimesters
- 64%
- Preconception exposure
- 89%
- Women continuing TNFi postpartum
- 68%
- TNFi use throughout all trimesters, 2011-2013
- 55%
- TNFi use throughout all trimesters, 2020-2021 (P for trend < 0.001)
- 73%
Observational data: associations, not effects.
Further findings
Corticosteroid use during pregnancy/postpartum
- Less frequent with TNFi throughout gestation vs first and/or second trimester only
Original publication
Patterns of Use and Discontinuation for Tumor Necrosis Factor Inhibitors in Pregnant Women: Insights From a Real-World Sample. J Rheumatol. Published 15 June 2025. doi:10.
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