Rheumatologic disorders

Anakinra Safe in Full-Term Pregnancy

Pregnant women treated with anakinra for a rheumatic disorder can experience a successful full-term pregnancy and give birth without major complications, according to study findings. 


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There is limited prospective data on the efficacy and safety of Interleukin-1 (IL-1) inhibitors during pregnancy.

For this study, the researchers reviewed medical records and maternal interviews of women pregnant between 2004 and 2017 to investigate their outcomes of pregnancy.


Five pregnancies with anakinra exposure were identified; 3 women received treatment for adult-onset Still disease, and 2 women had systemic juvenile idiopathic arthritis.  


All 5 women experienced full-term singleton live births with no major or long-term complications. 


Two women developed oligohydramnios—a deficiency of amniotic fluid—that can be related to fetal renal anomalies.


Two women had to undergo Caesarian sections, of which one was medically indicated and one was scheduled. 


Among the infants, one had low birth weight, but follow-up showed normal adjusted weight at 1 year. 


Three women successfully breastfed their infants, with at least 2 continuing treatment during breastfeeding.


“Given previously reported cases of congenital renal anomalies associated with both antenatal anakinra use and maternal hyperthermia, the relationship between maternal IL-1 inhibitor use, uncontrolled maternal febrile disease, and fetal outcomes should be further explored,” the researchers concluded.


—Melinda Stevens


Smith CJF, Chambers CD. Five successful pregnancies with antenatal anakinra exposure. Rheumatology. 2018;57(7):1271-1275.  

Learn more about the study by listening to our podcast with Dr Chelsey J. Forbess Smith here.