Psoriasis, pregnancy, and Humira

Some women see improvements in their psoriasis symptoms while they’re pregnant. Others experience worsening symptoms. Changes in psoriasis symptoms vary depending on the person. They can even change with each pregnancy you have.

No matter how pregnancy affects your psoriasis symptoms, you’re likely wondering what psoriasis treatments may be safe for you. Humira (adalimumab) is an injectable drug that’s used to treat psoriasis, as well as rheumatoid arthritis and psoriatic arthritis. Read on to learn more about Humira and whether it’s safe to use during pregnancy.

How does Humira treat psoriasis?

Psoriasis is a common autoimmune skin condition that can lead to scaling or inflammation. This is because psoriasis causes your body to overproduce skin cells.

For a person without psoriasis, typical cell turnover is three to four weeks. In that time, skin cells develop, rise to the top, and replace skin cells that have fallen off naturally or been washed off.

The life cycle of skin cells for a person with psoriasis is very different. Skin cells are created too quickly and don’t fall off fast enough. As a result, skin cells build up and the affected area becomes inflamed. This buildup may also cause scaly plaques of whitish-silvery skin.

Humira is a TNF-alpha blocker. TNF-alpha is a type of protein that contributes to the inflammation caused by psoriasis. By blocking these proteins, Humira works to improve psoriasis symptoms by reducing or slowing the body’s production of skin cells.

Is it safe to use Humira during pregnancy?

Humira is likely to be safe for use by pregnant women. A study of Humira in pregnant animals didn’t show any risk to the fetus. Clinical studies in humans didn’t show risk to the fetus either. These studies did indicate that the drug crosses the placenta in the greatest amount during the third trimester.

Despite this research, in most cases doctors will prescribe Humira during pregnancy only if the potential benefits are greater than the possible risks associated with using it. Most doctors treating psoriasis follow guidelines issued by the National Psoriasis Foundation. These guidelines recommend that for pregnant women with psoriasis, topical medications should be tried first.

Then, if those don’t work, they can try a “second-line” treatment such as Humira. The guidelines include a caveat, however, that drugs such as Humira should be used with caution and only when necessary.

All of this means that if you’re currently trying to get pregnant, you can likely continue treatment with Humira — but you should definitely talk to your doctor about it. And if you become pregnant, the only way to know if you should use Humira is to discuss your treatment with your doctor.

If you and your doctor decide that you’ll use Humira during pregnancy, you can take part in a pregnancy registry. Your doctor should call the toll-free number 877-311-8972 for information about the Organization of Teratology Information Specialists (OTIS) study and pregnancy registry.

Are there other psoriasis treatment options that are safe during pregnancy?

Your doctor can tell you about other treatment options during pregnancy. For instance, topical treatments such as moisturizers and emollients can be tried first to treat psoriasis during pregnancy. After that, your doctor may recommend low- to moderate-dose topical steroids. If necessary, high-dose topical steroids can be used in the second and third trimesters.

Another possible treatment for psoriasis in pregnant women is phototherapy.

What are the side effects of Humira?

The more common side effects of Humira are typically mild and include:

Many people experience side effects shortly after their first dose. In the majority of such cases, the side effects become less severe and less frequent following future doses.

When should I avoid using Humira?

Whether you’re pregnant or not, you shouldn’t use Humira in some situations. You may need to avoid taking this drug if you have a serious infection or a recurring or chronic infection. This includes infection with HIV, tuberculosis, invasive fungal disease such as aspergillosis, candidiasis, or pneumocystosis, or another bacterial, viral, or opportunistic infection.

If you’ve experienced symptoms of an infection such as fever, trouble breathing, or coughing, talk with your doctor about any potential risks of using Humira.

The takeaway

If you have psoriasis, talk with your doctor if you become pregnant. The two of you can adjust your treatment plan and discuss what to do if your symptoms become worse. If you use Humira, your doctor may suggest that you stop taking Humira during your third trimester, as that’s when your pregnancy would have the highest exposure to the drug. But whatever your doctor suggests, be sure to follow their guidance.

Throughout your pregnancy, keep in touch with your doctor and let them know about any changes in your psoriasis symptoms. They can help keep your symptoms in check and keep your pregnancy safe throughout these exciting nine months.