Can anti–TNF-alpha agents be taken by breastfeeding women with rheumatoid arthritis (RA)?

Updated: May 11, 2018
  • Author: Katherine K Temprano, MD; Chief Editor: Christine Isaacs, MD  more...
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Until more data are available on TNF-alpha antagonists and lactation, breastfeeding should probably be avoided during therapy with these agents. A prospective study in three nursing mothers treated with infliximab for Crohn disease found that infliximab was not detectable in their breast milk or in their infants' sera. [57]  These authors suggest that mothers who are taking infliximab should not be discouraged from breastfeeding. In case reports, however, small amounts of etanercept were found in the breast milk of lactating patients with RA; the risk this may pose is unknown. [58, 59]  

The EULAR guidelines find TNF-alpha agents compatible with breastfeeding; BSR-BHPR guidelines advise use with caution until further information is available. [18] [19]

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