The Efficacy and Safety of Cyclosporin A in Pregnant Patients with Systemic Autoimmune Diseases

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Abstract

Problem

Cyclosporin A (CYS A) is an immunosuppressant agent administered in autoimmune diseases, and its use during pregnancy and lactation is a debated topic.

Method of study

The demographic characteristics, the activity of the underlying disease, and the onset of fetal–maternal complications have been investigated in 21 consecutive patients (2 RA, 14 SLE, 2 PA, 1 SjS, 1 DM, 1 Churg–Strauss vasculitis), treated with CYS A throughout 29 gestations. A subanalysis of the SLE group was performed.

Results

We recorded a live birth rate of 86.2%. The median gestational age at birth was 38.2 weeks. The prevalence of maternal–fetal complications showed no differences with general population. Disease flares appeared in 4% of patients during gestation and in 12% during puerperium.

Conclusion

We found no evidence justifying the suspension of CYS A when a pregnancy occurs. The drug does not appear to promote maternal–fetal complications and should be continued in patients who benefit from therapy. Data regarding breast-feeding during therapy are still scarce, but no evidence of toxicity has emerged.

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