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Treatment Options for Pregnant People With PP


Experts discuss plaque psoriasis (PP) treatment options for people who are or may become pregnant.


Lauren Miller, MPAS, PA-C: I’m a woman. I have a 15-month-old [child], so I think back to my female patients with plaque psoriasis who want to become pregnant, aren’t sure if and when they might get pregnant, or even are pregnant. What options are there for those women? How do you approach that conversation with them?

TJ Chao, MPAS, PA-C: In general, the options are scarce. We don’t have a lot of great options. Using topical steroids in that population is definitely a good way to go. We also have an anti–TNF [tumor necrosis factor] agent, Cimzia [certolizumab pegol], that could be used to control the disease.

Lauren Miller, MPAS, PA-C: That’s the only biologic with an indication that shows that it’s safe for pregnancy.

TJ Chao, MPAS, PA-C: Right. Because it’s an Fab’ antibody, we know that it can’t cross the placenta and into the breast milk. That’s reassuring, and there are data to support that.

Lauren Miller, MPAS, PA-C: Depending on the severity, is that how you would predict whether you’re going to do topical medications vs a biologic?

TJ Chao, MPAS, PA-C: That’s an interesting question. There are a lot of patients who would be hesitant to use a systemic agent when they’re about to become pregnant or maybe are pregnant. They need a systemic agent, but they’re very concerned about the safety. Sometimes even if you tell them about the safety they’re still concerned. It’s a moving target. It’s a fluid situation with those patients.

Lauren Miller, MPAS, PA-C: Do you collaborate with their ob-gyn?

TJ Chao, MPAS, PA-C: I’ve made phone calls in the past. If I’m going to put them on a systemic agent, I’m going to call the ob-gyn and let them know. If they object, then they object, but I haven’t run into that situation.

Transcript edited for clarity.

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