医学
钙调神经磷酸酶
怀孕
他克莫司
狼疮性肾炎
硫唑嘌呤
子痫前期
系统性红斑狼疮
免疫学
胎儿
疾病
内科学
移植
遗传学
生物
作者
Yi Jiang,Min Tong,Jingjing Chen,Lihua Luo,Qingxia You,Hong Wu,Nian Zhang
标识
DOI:10.1016/j.ejogrb.2023.12.039
摘要
Systemic lupus erythematosus (SLE) predominantly affects child-bearing women, leading to an elevated risk of maternal and fetal complications and adverse pregnancy outcomes. Since some medications can cross the placental barrier that persist a threat to both mother and fetus, the risk–benefit ratio of SLE medications should be taken into consideration during pregnancy. Calcineurin inhibitor (CNI), mainly including cyclosporin A, tacrolimus, and voclosporin, is a category of immunosuppressive agents that inhibit calcium/calmodulin-dependent phosphatase calcineurin to block T cell activation. Based on the current clinical evidence, CNI is an alternative in pregnant SLE patients with persistent disease activity (especially lupus nephritis patients) and non-responders to azathioprine. However, there is no comprehensive review that summarizes the efficacy and safety profile of CNI for SLE management during pregnancy. This review presents a summary on the utilization of CNI for SLE management during pregnancy, including the mechanism of action, gestational amelioration of lupus flare, and the balance of maternal benefit-fetal risk, which may provide more references for the management of SLE pregnancies.
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