Biologic therapies for atopic diseases during pregnancy: A World Allergy Organization survey
Year: 2026
Type: article
Study design: Observational Study
Abstract: Rationale Biologic therapies are an increasingly important treatment option for atopic diseases, which commonly affect women of reproductive age. However, global barriers to prescribing biologic therapies to pregnant patients remain poorly understood. Methods The World Allergy Organization (WAO) Junior Members Steering Group conducted a global, web-based survey of healthcare professionals to evaluate prescribing patterns and barriers to the use of biologic therapies for atopic diseases during pregnancy. Results From 322 total participants representing 71 countries, 77 of 314 (24.5%) reported prescribing biologic therapies for atopic diseases during pregnancy. The most frequently prescribed biologic therapies during pregnancy were omalizumab (79.2%) and dupilumab (32.5%), followed by benralizumab (7.8%), mepolizumab (7.8%), tralokinumab (3.9%), tezepelumab (2.6%), and reslizumab (1.3%). Twenty-three respondents encountered barriers to prescribing biologic therapies to pregnant patients, including patients' concerns about the impact on pregnancy (82.6%), adverse reactions (47.8%), difficulty securing insurance coverage (13.0%), and high patient costs (8.7%). Reported biologic therapies discontinued due to pregnancy included dupilumab (39.1%), mepolizumab (26.1%), omalizumab (26.1%), and benralizumab (13.0%). Twelve of the 23 healthcare professionals who discontinued biologic therapies reported that their pregnant patients experienced worsening symptoms after stopping. Seven respondents (9.9%) reported adverse maternal or fetal outcomes in pregnant patients receiving biologic treatment for atopic diseases, including allergic/immune disorders (3), congenital defects (2), miscarriage (1), and preeclampsia (1). Only 42.3% of respondents who prescribed biologics to pregnant patients reported enrolling these patients in a pregnancy registry. Conclusions Significant barriers limit the prescriptions of biologic therapies for atopic diseases during pregnancy. Multidisciplinary collaboration among clinicians, researchers, and the pharmaceutical industry is essential for developing strategies to overcome these barriers and improve access to biologic therapy for pregnant patients.
Authors: Sergio E. Chiarella, Isabella Novoa-Caicedo, Sarah M. Jenkins, Divya Shah, Ishitha Jagadish, Leah Ishmael, Fnu Shakuntulla, Andrea Sitek, Barbara Kong-Cardoso, Isabel Fernandez de Alba, Duy Le Pham, Agnes Sze-yin Leung, Daria Levina, Shun Chi Ryan Lo, Matthew Norris, Nida Öztop, Thulja Trikamjee, Rosalaura Villarreal-Gonzalez, Yichao Wang, Lyda Cuervo-Pardo, Marco Caminati, Razvigor Darlenski, Alexei Gonzalez-Estrada, Ivana Filipovic, Tu HK. Trinh, Luciana Kase Tanno
Institutions: Mayo Clinic, University of Arizona, Mayo Clinic in Florida, University of South Florida, University of Kansas, Université de Montpellier, Institut Desbrest d'Epidémiologie et de Santé Publique, Hospital CUF Descobertas, Universidade Nova de Lisboa, University of Medicine and Pharmacy at Ho Chi Minh City, Chinese University of Hong Kong, Sechenov University, University of British Columbia, Guthrie Foundation, İstanbul Başakşehir Çam ve Sakura Şehir Hastanesi, University of Cape Town, Universidad Autónoma de Nuevo León, Hospital Universitario Dr José Eleuterio Gonzalez, Deakin University, The University of Melbourne, Murdoch Children's Research Institute, University of Florida, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Trakia University, Mayo Clinic in Arizona, University Hospital Center Dr Dragiša Mišović, Trung tâm Y Sinh học Phân tử, Inserm, Centre Hospitalier Universitaire de Montpellier
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,508
OpenAlex ID: W7225205667