79 A subsequent systematic review of four cohort studies in psoriasis patients identified an increased odds of teratogenicity or preterm birth in anti-TNF treated patients in several studies, but this did not reach statistical significance in all of them. 80 The quality of evidence of all four studies included in this review was classified as “very low” using an adapted GRADE toolkit due to various sources of bias, inconsistency and studies being carried out in indirect populations of women without known psoriasis.
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Biologics in Psoriasis: Updated Perspectives on Long-Term Safety and Risk Management.
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