Immunosuppressives and biologics during pregnancy and lactation

Abstract

The present consensus report issued by the Austrian Society of Gastroenterology and Hepatology (Österreichische Gesellschaft für Gastroenterologie und Hepatologie; ÖGGH) and the Austrian Society of Rheumatology and Rehabilitation (Österreichische Gesellschaft für Rheumatologie und Rehabilitation; ÖGR) is intended to provide practical guidelines for the application of immunosuppressives and biologics in pregnancy and the lactation period. The contributors to this consensus, who are also the authors of this report, drafted its text body and recommendations regarding the medications currently in use (Delphi process). All consensus participants are members of their respective specialist societies and have many years of experience in the treatment of outpatient and inpatient subjects with immunosuppressives and biologics. This body of expertise was complemented by three specialists in gynecology, dermatology and embryology, respectively. The recommendations and text are based on the available literature (systematic literature review by means of MEDLINE/PubMed, the Cochrane Database and abstracts from relevant international conferences) and were scrutinized according to the levels of evidence (EL) and grades of recommendation (RG) set forth by the Oxford Centre for Evidence-Based Medicine (Table 1 ). The consensus participants elaborated the statements and put them to vote on the occasion of a meeting on 13 October 2016. A statement was considered consented if it received 80% or more approval. Prior to printing, the statements and references were updated according to the current status of the literature (July 2018). The individual participants composed and edited the chapters of the consensus report, and all participants approved the final version. The substances and consensus recommendations regarding substance application preconception, during pregnancy and during lactation were summerized in Fig. 1 .