Is Canakinumab Safe During Pregnancy? New Insights from Three Cases in Slovakia

<b>Background and Objectives</b>: Canakinumab, a human recombinant monoclonal antibody against interleukin-1ß (IL-1ß), is indicated for the treatment of selected autoinflammatory periodic fever syndromes and rheumatic diseases. Data on its use during pregnancy remain limited and all are...

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Main Authors: Branislav Slenker, Katarina Hrubiskova, Lenka Kapustova, Anna Bobcakova, Juraj Ondris, Milos Jesenak
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Biologics
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Online Access:https://www.mdpi.com/2673-8449/5/2/12
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author Branislav Slenker
Katarina Hrubiskova
Lenka Kapustova
Anna Bobcakova
Juraj Ondris
Milos Jesenak
author_facet Branislav Slenker
Katarina Hrubiskova
Lenka Kapustova
Anna Bobcakova
Juraj Ondris
Milos Jesenak
author_sort Branislav Slenker
collection DOAJ
description <b>Background and Objectives</b>: Canakinumab, a human recombinant monoclonal antibody against interleukin-1ß (IL-1ß), is indicated for the treatment of selected autoinflammatory periodic fever syndromes and rheumatic diseases. Data on its use during pregnancy remain limited and all are primarily derived from case reports. Although animal studies indicate no evidence of reproductive toxicity, the risk to the fetus or mother remains unknown. This study aims to provide more findings about this important topic. <b>Methods</b>: A retrospective analysis was conducted on three patients followed and treated in the National Center for Periodic Fever Syndromes. Although due to the small sample size, no general conclusions regarding the safety of canakinumab during pregnancy can be drawn. <b>Results</b>: Three maternal-exposed pregnancies were assessed, with no paternal exposure. Diagnoses included mevalonate kinase deficiency, familiar Mediterranean fever and TNF-receptor-associated periodic syndrome. All mothers were treated with canakinumab, and two of those continued the canakinumab treatment during the whole course of pregnancy. The diseases remained under full control during pregnancy, enabling conception in two cases where attempts prior to treatment were unsuccessful. The therapy led to disease control, a reduction in inflammation and subsequently successful conception. One patient underwent IVF repeatedly. All pregnancies resulted in three healthy infants, with no reported miscarriages during the canakinumab-exposed pregnancies, no complications during pregnancies and no serious infections in the newborns. The children had normal development, without any developmental delays or chronic illnesses. <b>Conclusions</b>: The current data, including our findings, indicate no harmful effects of canakinumab during pregnancy. However, because of the scarcity of data, the use of canakinumab during pregnancy should be carefully managed, and women who want to become pregnant should continue treatment only after a thorough benefit–risk evaluation.
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spelling doaj-art-6e76d9aefb4e43a598cafcf1abcd59372025-08-20T03:26:15ZengMDPI AGBiologics2673-84492025-04-01521210.3390/biologics5020012Is Canakinumab Safe During Pregnancy? New Insights from Three Cases in SlovakiaBranislav Slenker0Katarina Hrubiskova1Lenka Kapustova2Anna Bobcakova3Juraj Ondris4Milos Jesenak5National Centre for Periodic Fever Syndromes, Department of Pediatrics and Adolescent Medicine, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital, 036 01 Martin, SlovakiaNational Centre for Periodic Fever Syndromes, 5th Internal Clinic, Faculty of Medicine, Comenius University and Slovak Medical University in Bratislava, University Hospital, 826 06 Bratislava, SlovakiaNational Centre for Periodic Fever Syndromes, Department of Pediatrics and Adolescent Medicine, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital, 036 01 Martin, SlovakiaNational Centre for Periodic Fever Syndromes, Department of Pediatrics and Adolescent Medicine, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital, 036 01 Martin, SlovakiaDepartment of Laboratory Medicine, Faculty of Health Care and Social Work, Trnava University, 917 01 Trnava, SlovakiaNational Centre for Periodic Fever Syndromes, Department of Pediatrics and Adolescent Medicine, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital, 036 01 Martin, Slovakia<b>Background and Objectives</b>: Canakinumab, a human recombinant monoclonal antibody against interleukin-1ß (IL-1ß), is indicated for the treatment of selected autoinflammatory periodic fever syndromes and rheumatic diseases. Data on its use during pregnancy remain limited and all are primarily derived from case reports. Although animal studies indicate no evidence of reproductive toxicity, the risk to the fetus or mother remains unknown. This study aims to provide more findings about this important topic. <b>Methods</b>: A retrospective analysis was conducted on three patients followed and treated in the National Center for Periodic Fever Syndromes. Although due to the small sample size, no general conclusions regarding the safety of canakinumab during pregnancy can be drawn. <b>Results</b>: Three maternal-exposed pregnancies were assessed, with no paternal exposure. Diagnoses included mevalonate kinase deficiency, familiar Mediterranean fever and TNF-receptor-associated periodic syndrome. All mothers were treated with canakinumab, and two of those continued the canakinumab treatment during the whole course of pregnancy. The diseases remained under full control during pregnancy, enabling conception in two cases where attempts prior to treatment were unsuccessful. The therapy led to disease control, a reduction in inflammation and subsequently successful conception. One patient underwent IVF repeatedly. All pregnancies resulted in three healthy infants, with no reported miscarriages during the canakinumab-exposed pregnancies, no complications during pregnancies and no serious infections in the newborns. The children had normal development, without any developmental delays or chronic illnesses. <b>Conclusions</b>: The current data, including our findings, indicate no harmful effects of canakinumab during pregnancy. However, because of the scarcity of data, the use of canakinumab during pregnancy should be carefully managed, and women who want to become pregnant should continue treatment only after a thorough benefit–risk evaluation.https://www.mdpi.com/2673-8449/5/2/12autoinflammatory diseasescanakinumabinflammationinterleukin-1pregnancysafety
spellingShingle Branislav Slenker
Katarina Hrubiskova
Lenka Kapustova
Anna Bobcakova
Juraj Ondris
Milos Jesenak
Is Canakinumab Safe During Pregnancy? New Insights from Three Cases in Slovakia
Biologics
autoinflammatory diseases
canakinumab
inflammation
interleukin-1
pregnancy
safety
title Is Canakinumab Safe During Pregnancy? New Insights from Three Cases in Slovakia
title_full Is Canakinumab Safe During Pregnancy? New Insights from Three Cases in Slovakia
title_fullStr Is Canakinumab Safe During Pregnancy? New Insights from Three Cases in Slovakia
title_full_unstemmed Is Canakinumab Safe During Pregnancy? New Insights from Three Cases in Slovakia
title_short Is Canakinumab Safe During Pregnancy? New Insights from Three Cases in Slovakia
title_sort is canakinumab safe during pregnancy new insights from three cases in slovakia
topic autoinflammatory diseases
canakinumab
inflammation
interleukin-1
pregnancy
safety
url https://www.mdpi.com/2673-8449/5/2/12
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