Maladies inflammatoires chroniques intestinales, traitements médicamenteux et grossesse : Quoi de neuf en 2024 ?

Two recurring questions arise for gastroenterologists in charge of patients with inflammatory bowel disease (IBD). Does treatment of IBD with immunosuppressants or biotherapy have an impact on fertility in men, and on the subsequent development of a pregnancy in the couple? In pregnant women, when is the best time to stop anti-TNF treatment during pregnancy, and when should the newborn be offered a live attenuated vaccine? A review of the literature and a meta-analysis collated studies describing the consequences of IBD treatment with biotherapy or immunosuppressants on spermatogenesis and the evolution of a possible pregnancy in the couple. Sperm analysis, including sperm count, morphology, and motility, did not differ with or without treatment. No adverse pregnancy events (miscarriage, prematurity and congenital malformation) were significantly different whether or not the male parents received treatment for their IBD. Recommendations concerning the use of biotherapies have recently been drawn up by the European group ECCO (European Crohn's and -Colitis -Organisation). A physiologically-based pharmacokinetic modelling study of -biotherapies in both pregnant women and exposed children sought to predict the ideal time for the last biotherapy injection, taking into account the mother's dose and the intervals between injections or infusions. [ABSTRACT FROM AUTHOR]