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MotherToBaby

Medications and More during pregnancy and breastfeeding

Tocilizumab (Actemra®)

Selected References:

  • Dalkilic E, et al. 2019. A successful pregnancy in a patient with Takayasu’s arteritis under tocilizumab treatment: A longitudinal case study. Int J Rheum Dis; 22(10)L 1941-1944. 
  • Dernoncourt A, et al. 2023. Fetal and neonatal adverse drug reactions associated with biologics taken during pregnancy by women with autoimmune diseases: Insights from an analysis of the World Health Organization Pharmacovigilance Database (VigiBase®). BioDrugs; 37(1):73-87. 
  • Förger F & Villiger PM. 2016. Treatment of rheumatoid arthritis during pregnancy: present and future. Expert Rev of Clin Immun; 12(9):937 944. Genentech, Inc. Actemra Prescribing Information. 2025. Available online at: https://www.gene.com/download/pdf/actemra_prescribing.pdf Accessed 27 Jan 2026.  
  • Götestam Skorpen C, et al. 2016. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Annals of the Rheum Dis; 75:795-810. 
  • Hoeltzenbein M, et al. 2016. Tocilizumab use in pregnancy: analysis of a global safety database including data from clinical trials and post-marketing data. Sem Arthr Rheum; 466(2):238–245. 
  • Hyrich KL and Verstappen SM. 2014. Biologic therapies and pregnancy: the story so far. Rheumatology (Oxford); 53(8):1377-85.  
  • Isaac B, et al. 2023. Maternal and fetal outcome in pregnant women with critical COVID-19 treated with tocilizumab in a tertiary care hospital in Dubai. Cureus; 30;15(1):e34395. 
  • Jimenez-Lozano I, et al. 2021. Safety of tocilizumab in COVID-19 pregnant women and their newborn: A retrospective study. J Clin Pharm Ther; 46:1062-1070.  
  • Jorgensen S & Lapinsky SE. 2022. Tocilizumab for coronavirus disease 2019 in pregnancy and lactation: a narrative review. Clin Microbiol Infect; 28(1):51-57.  
  • Konagai N, et al. 2023. Safe use of tocilizumab in pregnant women with Takayasu arteritis: three case studies. RMD Open 9:e002996. 
  • Kaneko K, et. al. 2016. Tocilizumab and pregnancy: Four cases of pregnancy in young women with rheumatoid arthritis refractory to anti-TNF biologics with exposure to tocilizumab. Mod Rheumtol; 26(5):672-675.  
  • Levy RA, et. al. 2016. Critical review of the current recommendations for the treatment of systemic inflammatory rheumatic diseases during pregnancy and lactation. Autoimmun Rev; 15(10):955-963. 
  • Moriyama M, et al. 2020. Unexpectedly lower proportion of placental transferred tocilizumab relative to whole immunoglobulin G: a case report. Scand J Rheumatol; 49(2):165-166. 
  • Nakajima K, et. al. 2016. Pregnancy outcomes after exposure to tocilizumab: A retrospective analysis of 61 patients in Japan. Mod Rheumtol; 26(5):667-671. 
  • Nana M, et al. 2024. Use of interleukin-6 receptor antibodies in the second and third trimester of pregnancy: a retrospective cohort study. Lancet Rheumatol; 6(9): e625-e635. 
  • Ostensen M and Förger F. 2011. Treatment with biologics of pregnant patients with rheumatic diseases. Curr Opin Rheumatol; 23(3):293-8.  
  • Pham T, et al. 2010.Tocilizumab: therapy and safety management. Joint Bone Spine; 77 Suppl 1:S3-100.  
  • Rubbert-Roth A, et al. 2010. First experiences with pregnancies in RA patients receiving tocilizumab therapy. [abstract]. Arthritis Rheum; 62 Suppl 10:384.  
  • Saito J et. al. 2019. Tocilizumab during pregnancy and lactation: drug levels in maternal serum, cord blood, breast milk and infant serum. Rheumatology (Oxford); 58(8):1505-1507.  
  • Weber-Schoendorfer C and Schaefer C. 2016. Pregnancy outcome after tocilizumab therapy in early pregnancy-a case series from the German Embryotox Pharmacovigilance Center. Reprod Toxicology; 60:29–32. 

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