Biologic therapies for atopic diseases during pregnancy: A World Allergy Organization survey

@article{sergioechiarella2026biologic,
  title = {{Biologic therapies for atopic diseases during pregnancy: A World Allergy Organization survey}},
  author = {Sergio E. Chiarella, MD and Isabella Novoa-Caicedo, MD and Sara M. Jenkins, MS and Divya Shah, MD and Ishitha Jagadish, MD and Leah Ishmael, DO and Fnu Shakuntulla, MD and Andrea Sitek, MD and Barbara Kong-Cardoso, MD and Isabel Fernandez de Alba, MD and Duy Le Pham, MD, PhD and Agnes Sze-yin Leung, MBChB and Daria Levina, MD, MSc and Shun Chi Ryan Lo, MD and Matthew Norris, MD and Nida Öztop, MD and Thulja Trikamjee, MD and Rosalaura Villarreal-Gonzalez, MD, PhD and Yichao Wang, MD, PhD and Lyda Cuervo-Pardo, MD and Marco Caminati, MD and Razvigor Darlenski, MD, PhD and Alexei Gonzalez-Estrada, MD and Ivana Filipovic, MD, PhD and Tu HK. Trinh, MD, PhD and Luciana Kase Tanno, MD, PhD},
  journal = {World Allergy Organization Journal},
  year = {2026},
  month = nov,
  doi = {10.1016/j.waojou.2026.101485},
  url = {https://doi.org/10.1016/j.waojou.2026.101485},
  note = {CC BY},
}

TY  - JOUR
TI  - Biologic therapies for atopic diseases during pregnancy: A World Allergy Organization survey
AU  - Sergio E. Chiarella, MD
AU  - Isabella Novoa-Caicedo, MD
AU  - Sara M. Jenkins, MS
AU  - Divya Shah, MD
AU  - Ishitha Jagadish, MD
AU  - Leah Ishmael, DO
AU  - Fnu Shakuntulla, MD
AU  - Andrea Sitek, MD
AU  - Barbara Kong-Cardoso, MD
AU  - Isabel Fernandez de Alba, MD
AU  - Duy Le Pham, MD, PhD
AU  - Agnes Sze-yin Leung, MBChB
AU  - Daria Levina, MD, MSc
AU  - Shun Chi Ryan Lo, MD
AU  - Matthew Norris, MD
AU  - Nida Öztop, MD
AU  - Thulja Trikamjee, MD
AU  - Rosalaura Villarreal-Gonzalez, MD, PhD
AU  - Yichao Wang, MD, PhD
AU  - Lyda Cuervo-Pardo, MD
AU  - Marco Caminati, MD
AU  - Razvigor Darlenski, MD, PhD
AU  - Alexei Gonzalez-Estrada, MD
AU  - Ivana Filipovic, MD, PhD
AU  - Tu HK. Trinh, MD, PhD
AU  - Luciana Kase Tanno, MD, PhD
PY  - 2026
DA  - 2026/11/05
JO  - World Allergy Organization Journal
DO  - 10.1016/j.waojou.2026.101485
UR  - https://doi.org/10.1016/j.waojou.2026.101485
AB  - 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.
SN  - 1939-4551
ER  -