skip to main content

Psoriasis in Pregnancy — SCE Dermatology MCQ

Instant feedback + full explanation. One question, done properly.

HardDermatopharmacologyPsoriasis in PregnancySCE Dermatology

A 30-year-old woman with psoriasis is planning pregnancy. She is currently well-controlled on Adalimumab. What is the guidance on anti-TNF biologic use during pregnancy?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Can be continued through the first and second trimesters; consider stopping at week 20 (Adalimumab) or week 16 (Infliximab) to minimise neonatal immunosuppression

Anti-TNF biologics (Adalimumab, Infliximab, Certolizumab, Etanercept) cross the placenta predominantly in the third trimester via active FcRn-mediated IgG transport. BSR/BAD guidelines recommend continuing anti-TNF therapy through the first two trimesters to maintain disease control, then considering cessation at gestational week 20 for Adalimumab (week 16 for Infliximab) to minimise neonatal drug levels. Certolizumab pegol (Fab fragment without Fc, so minimal placental transfer) may be continued throughout pregnancy. Live vaccines should be deferred in the infant for 6 months if exposed to anti-TNF in utero. Methotrexate and Acitretin are absolutely contraindicated.

Reference: BAD 2018 Pregnancy Guidelines; BSR 2016