Use of interleukin-6 receptor antibodies in the second and third trimester of pregnancy: a retrospective cohort study
Authors' conclusion
We report further data on the use of anti-IL-6 in the second and third trimesters of pregnancy for the management of COVID-19.
Study context
- Population
- Pregnant women with COVID-19 treated with an IL-6R antibody (tocilizumab or sarilumab) after the first trimester, and their neonates, two tertiary hospitals in London, UK, March 1, 2020–Sept 30, 2022followed up for 12 months
- Participants
- 25 women
- Exposure
- Third trimester vs Second trimester
- Third trimestern = 16
- Second trimestern = 9
- Outcome
- Maternal and neonatal outcomes after anti-IL-6 exposure
Methodological detailstwo tertiary hospitals
- Two tertiary hospitals
Main finding
As reported in the abstract
- Women requiring level two or three critical care
- 24
- Received tocilizumab
- 24
- Received sarilumab
- 1
- Livebirths
- All pregnancies
- Babies born preterm
- 16 of 26
Observational data: associations, not effects.
Safety
Maternal adverse outcomes
- Maternal neutropenia or pancytopenia
- 0
- Liver enzyme increases (in keeping with COVID-19 severity)
- 16 of 20
- Secondary bacterial infection, all mounted a CRP response
- 3
- Maternal death due to COVID-19
- 1
Neonatal adverse outcomes
- Death at age 6 months due to complications of extreme prematurity
- 1
- Transient neonatal cytopenia
- six of 19
- Likely in keeping with prematurity alone; transplacental transfer of anti-IL-6 cannot be excluded
Original publication
Use of interleukin-6 receptor antibodies in the second and third trimester of pregnancy: a retrospective cohort study. Lancet Rheumatol. Published 5 August 2024. doi:10.
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