JAK inhibitors
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A JAK inhibitor might occasionally be used in pregnancy if recommended by a specialist.
What are they?
The JAK inhibitors are a group of drugs used to treat allergic and inflammatory illnesses, such as severe eczema, psoriasis, Crohn’s disease, and rheumatoid arthritis.
JAK inhibitors include abrocitinib (Cibinqo®), baricitinib, delgocitinib (Anzupgo®), deucravacitinib (Sotyktu®), filgotinib (Jyseleca®), ritlecitinib (Litfulo®), ruxolitinib (Jakavi®), tofacitinib (Xeljanz®), and Upadacitinib (Rinvoq®).
Benefits
What are the benefits of using a JAK inhibitor in pregnancy?
JAK inhibitors can be very effective for treating pain and inflammation. Good control of the symptoms caused by your medical condition means that you can stay well and carry on with your normal life.
Poorly controlled inflammatory illnesses including inflammatory bowel disease can increase the risk of some pregnancy complications. Use of a JAK inhibitor can help to prevent these complications.
Risks
Are there any risks of taking a JAK inhibitor during pregnancy?
The very small amount of available information on use of JAK inhibitors in pregnancy does not show that they harm the baby. More research is needed to confirm this.
As a precaution, you will only be offered a JAK inhibitor in pregnancy when other treatments have not worked for you and the benefits of using a JAK inhibitor to keep you well outweigh the possible risks. Your doctor will help you decide whether a JAK inhibitor should be continued in pregnancy.
Alternatives
Are there any alternatives to taking a JAK inhibitor?
Possibly. Other medicines can be used to treat allergies and inflammatory illness but they might not work as well as a JAK inhibitor. If your medical condition is well-controlled with a JAK inhibitor, staying on it may be the safest option to keep you well and avoid pregnancy complications.
If you are planning a pregnancy, please speak to your GP or specialist to determine whether a JAK inhibitor is still the best medicine. If you have an unplanned pregnancy while using a JAK inhibitor, you should be reviewed at the earliest opportunity by your GP or specialist.
No treatment
What if I prefer not to take medicines during pregnancy?
It is important that inflammatory illness is correctly treated during pregnancy to reduce the chance of complications for you and your baby.
It is also important that 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?
All pregnant women in the UK will be offered a very detailed anomaly scan, usually at around 20 weeks of pregnancy, as part of their routine antenatal care. If you have used a JAK inhibitor in the first trimester you may be offered this scan slightly earlier than usual.
Are there any risks to my baby if the father has taken a JAK inhibitor?
We do not expect any increased risk to your baby if the father takes a JAK inhibitor.
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.