Was Risk Properly Assessed in Carter, et al’s Safety Assessment of Tumor Necrosis Factor Antagonists During Pregnancy?

Abstract

To the Editor: We read with great interest the article by Carter, et al 1, which is the first to suggest that women exposed to tumor necrosis factor-α (TNF) antagonists during pregnancy may experience an increased risk of congenital anomalies. Thus this report may have a chilling effect on utilization of these medications in women of child-bearing age suffering conditions that might benefit from their use. Moreover, these drugs are currently being investigated for their use prior to pregnancy. We applaud the authors for recognizing “limitations” that might compromise the reliability of their findings. However, the limitations listed in the Discussion1 are not reflected in the data analysis found in the Results1. The article follows an abstract presented at the 2007 American College of Rheumatology/Association of Rheumatology Health Professionals meeting2. We are aware of 2 commentaries. Each broaches important questions regarding the article’s … Address correspondence to Dr. Winger; E-mail: ewinger{at}sbcglobal.net