Enbrel, Preganacy and Adult Onset Still's Disease

Question  I am 31 years old and have been taking Enbrel for a couple of years for Adult Onset Still's Disease. I disconintued the medication about 4 weeks ago when I found out I was pregnant. I noticed no problems until last thursday when I started getting a rash. At first I thought is was just an allergic rash but as it got progessively worse I had flashbacks of four years ago when I first was diagnosed with Still's. I had a rash,months of fever, and extreme joint swelling/pain. My rhematologist indicated that if the rash got worse he would probably go ahead and take the Enbrel. He said that everyone seems to think that it will not hurt the baby. My husband and I decided on saturday to give the shot- we thought a flare-up would probably be worse on the baby than the medication. Do you have any insight on using Enbrel during preganacy? Would a flare-up or Enbrel put the baby at greater risk?
 
Answer  There is not enough good data to be definitive in answering your question. There are no tests (and there will never be any tests) of Enbrel during pregnancy. However the small number of reports suggest that Enbrel does not cause an increase risk of fetal problems. Also, I am not aware of any information of prenancy and Adult Still's Disease. If you have gotten very ill during your prior episodes of Still's, I would be concerned. I think I would try NSAIDs and prednisone (drugs considered safe during pregnancy) before moving to Enbrel. Discuss with your doctor.

Last update: 07:28 PM Tuesday, April 10, 2007

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Author:

Alan Matsumoto, M.D.

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