Givosiran for the Treatment of Hereditary Coproporphyria in Pregnancy: A Case Report.

Hereditary coproporphyria (HCP) is a rare autosomal dominant disorder of heme synthesis characterized by acute neurovisceral attacks that are often precipitated by exposure to medications or hormones. Patients with HCP who become pregnant have an elevated risk of more frequent neurovisceral attacks and other obstetric complications. Givosiran, a small interfering RNA therapeutic, is considered the gold-standard prophylactic treatment for acute hepatic porphyrias, but its use has not been studied during pregnancy. We describe our patient who successfully continued givosiran throughout pregnancy. This highlights the role of shared decision-making in managing medically complex patients during pregnancy when treatment data may be limited or non-existent and the need for further investigation into the safety profile of givosiran use in pregnancy.