Is Canakinumab Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Canakinumab? Is Canakinumab safe for nursing mother and child? Does Canakinumab extracts into breast milk? Does Canakinumab has any long term or short term side effects on infants? Can Canakinumab influence milk supply or can Canakinumab decrease milk supply in lactating mothers?

No information is available on the passage of canakinumab into breastmilk. Because canakinumab is a large protein molecule with a molecular weight of 145,157, the amount in milk is likely to be very low and absorption is unlikely because it is probably destroyed in the infant's gastrointestinal tract. Until more data become available, canakinumab injection should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant. Topical or homeopathic preparations pose little risk to the nursing infant. Canakinumab 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%.[1][2] 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%.[3] None of the studies measured IgG activity.

In an international multicenter study of mothers exposed to interleukin-1 receptor antagonists, 4 babies were breastfed (extent not stated) by mothers receiving regular canakinumab. It is unclear if mothers received the drug postpartum or only during pregnancy. There were no reported serious infections and no developmental abnormalities at a mean follow-up of 2.2 years (range 5 months to 4 years).[4]