Tocilizumab

PMID: 29999649

Abstract:

Little information is available on the clinical use of tocilizumab during breastfeeding. Only small amounts of tocilizumab were detected in breastmilk after intravenous doses in several mothers, and a few mothers have breastfed their infants with undetectable infant serum levels and no reported adverse effects. If tocilizumab is required by the mother, it is not a reason to discontinue breastfeeding.[1,2] Until more data become available, tocilizumab should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant.
Tocilizumab is a human immunoglobulin G1 (IgG1) kappa antibody. Holder pasteurization (62.5 degrees C for 30 minutes) decreases the concentration of endogenous immunoglobulin G by up to 79%.[3-5] A study of 67 colostrum samples that underwent Holder pasteurization found that IgG amounts decreased by 34 to 40%. Specific IgG subclasses decreased by different amounts, with IgG1 activity decreasing by about 37%.[6] None of the studies measured IgG activity.

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