Dupilumab
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Dupilumab can be used in pregnancy if advised by a specialist. Babies exposed in the womb after the first trimester might be offered some of their vaccinations later than usual.
What is it?
Dupilumab (Dupixent®) is an antibody therapy used to treat allergic conditions, such as asthma and atopic dermatitis (skin allergy). Dupilumab is also occasionally used to treat severe chronic rhinosinusitis (long-term blocked nose and inflamed sinuses).
Benefits
What are the benefits of using dupilumab in pregnancy?
Dupilumab treats asthma and is often used when other asthma medications have not been effective. Good control of asthma in pregnancy is important to prevent serious complications for both you and your baby.
Dupilumab can reduce skin reactions and itching if you have atopic dermatitis. This can help you to sleep better and allow you to carry on with your normal life, as well as reduce the chance of skin infections caused by scratching.
Dupilumab can improve your quality of life by reducing sinus pain and improving a blocked nose if you have chronic rhinosinusitis.
Risks
What are the risks of using dupilumab in pregnancy?
Dupilumab does not cross the placenta in the first trimester so will not directly affect your baby’s development. Only around 95 women using dupilumab in pregnancy have been studied. No problems were identified but further research is ideally required.
Some antibody treatments used in later pregnancy might affect the baby’s immune system for several months after birth. Live vaccines should be avoided during this time. It is unclear whether dupilumab has this effect. As a precaution, your baby may not be offered the live vaccine against rotavirus as this needs to be completed by four months of age. If your baby requires the live BCG vaccine to protect against catching TB, the vaccination might not be given until your baby is at least six months old. Your doctor will be able to advise about the best time for your baby’s vaccinations.
Alternatives
Are there any alternatives to using dupilumab in pregnancy?
Possibly. Other medicines can be used to treat allergic conditions during pregnancy, although these may not work as well as dupilumab. If dupilumab is working for you, your specialist might advise that staying on it during pregnancy is the best option.
If you are planning a pregnancy or have an unplanned pregnancy while taking dupilumab, speak to your specialist about which medicine is best.
No treatment
What if I prefer not to take medicines during pregnancy?
It is important that asthma is correctly treated during pregnancy to reduce the chance of complications for you and your baby.
It is also important that other allergic conditions are well-treated to keep you well and ensure you can sleep properly and carry on with your normal life.
Your doctor will be happy to discuss any concerns about medicines prescribed in pregnancy.
Will I or my baby need extra monitoring?
As part of routine antenatal care in the UK, women are invited for a very detailed scan at around 20 weeks of pregnancy to check the baby’s development. No further scans to check for birth defects will be required due to use of dupilumab.
Are there any risks to my baby if the father has used dupilumab?
There is currently no evidence that dupilumab used by the father can harm your baby through effects on the sperm.
Who can I talk to if I have questions?
If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.