Immunomodulators.(Drugs, Pregnancy, And Lactation)

Several immunologic agents--adalimumab, anakinra, etanercept, three classes of interferons, and thalidomide--are classified in the general category of immunomodulators. They are used for various approved and off-label indications, including multiple sclerosis, rheumatoid arthritis, autoimmune disorders, and complications of leprosy, and for antitumor, antiviral, and antibacterial uses.

With the exception of thalidomide, these compounds are large molecules, so they may not reach the fetus. But their complex pharmacologic mechanisms may have direct effects on a number of maternal biologic processes, such as immune functions, response to infections and inflammation, cell proliferation, leukocyte migration, and prevention of cartilage …