Is Belimumab compatible with breastfeeding? Do we have alternatives for Belimumab?

Belimumab

August 23, 2016 (Low Risk)

IgG1λ human monoclonal antibody that is used for the treatment of lupus erythematosus.

At latest update no published data on excretion into breast milk were found.

Because a high molecular weight, excretion into breast milk makes is unlikely. Its protein-like composition would facilitate its destruction in the stomach, thus preventing the infant intestinal absorption, except in preterm and immediate neonatal period in which they may have an increased intestinal permeability.

The European League Against Rheumatism (EULAR) does not recommend against breastfeeding on mothers treated with Belimumab, if no other therapeutic alternative is available.

Alternatives

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Writings

  • بيليموماب (Arabic)
  • Белимумаб (Cyrillic)
  • 贝利木单抗 (Chinese)
  • ベリムマブ (Japanese)

Drug trade names

References

  1. Noviani M, Wasserman S, Clowse ME. Breastfeeding in mothers with systemic lupus erythematosus. Lupus. 2016Abstract
  2. Götestam Skorpen C, Hoeltzenbein M, Tincani A, Fischer-Betz R, Elefant E, Chambers C, da Silva J, Nelson-Piercy C, Cetin I, Costedoat-Chalumeau N, Dolhain R, Förger F, Khamashta M, Ruiz-Irastorza G, Zink A, Vencovsky J, Cutolo M, Caeyers N, Zumbühl C, Østensen M. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis. 2016Abstract Full text (link to original source) Full text (in our servers)
  3. Calligaro A, Hoxha A, Ruffatti A, Punzi L. Are biological drugs safe in pregnancy? Reumatismo. 2015Abstract Full text (link to original source) Full text (in our servers)
  4. Auyeung-Kim DJ, Devalaraja MN, Migone TS, Cai W, Chellman GJ. Developmental and peri-postnatal study in cynomolgus monkeys with belimumab, a monoclonal antibody directed against B-lymphocyte stimulator. Reprod Toxicol. 2009Abstract