The effects of long-term exposure to disease-modifying drugs during pregnancy in multiple sclerosis

详细信息    查看全文

• 作者：Yara Dadalti Fragoso^a ; ^{yara@bsnet.com.br} ; Mike Boggild^b ; Miguel Angel Macias-Islas^c ; Adriana Carra^d ; Kirsty Deborah Schaerer^e ; Adriana Aguayo^c ; Sandra Maria Garcia de Almeida^f ; Marcos Papais Alvarenga^g ; Regina Maria Papais Alvarenga^g ; Soniza Vieira Alves-Leon^f ; Walter Oleschko Arruda^h ; Joseph Bruno Bidin Brooks^a ; Elizabeth Regina Comini-Frotaⁱ ; Maria Lucia Brito Ferreira^j ; Alessandro Finkelsztejn^k ; Juliana Marcon Szymanski Finkelsztejn^k ; Lucas Dias de Freitas^j ; Andre Serafin Gallina^l ; Paulo Diniz da Gama^m ; Sergio Georgettoⁿ ; Maria Cristina B. Giacomo^o ; Sidney Gomes^p ; ^q ; Marcus Vinicius Magno Gonç ; alves^r ; Anderson Kuntz Grzesiuk^s ; Damacio Ramon Kaimen-Macielⁿ ; Josiane Lopesⁿ ; Giselle A. Lourenco^f ; Fabiola Rachid Malfetano^g ; Nivea Macedo Oliveira Morales^t ; Rogerio de Rizo Morales^t ; Celso Luis Silva Oliveira^a ; Patricia Onaha^d ; Cristiane Patroclo^g ; Sonia Beatriz Felix Ribeiro^u ; Taysa Alexandrino Gonsalves Jube Ribeiro^v ; Heidi Johanna Salminen^w ; Patricia Santoro^x ; Marcos Seefeld^y ; Paula Vallegas Soares^a ; Adriana Tarulla^x ; Claudia Cristina Ferreira Vasconcelos^g
• 关键词：Multiple sclerosis ; Pregnancy ; Interferon beta ; Glatiramer acetate
• 刊名：Clinical Neurology and Neurosurgery
• 出版年：2013
• 出版时间：February, 2013
• 年：2013
• 卷：115
• 期：2
• 页码：154-159
• 全文大小：332 K

文摘

Background and objective

Women with multiple sclerosis (MS) who intend to get pregnant are often advised to discontinue disease modifying therapy (DMT) prior to conception. This recommendation is not based on medical evidence and may interfere with disease control by immunomodulatory drugs. The present study was designed to help discuss the effect of DMT for MS on pregnancy and on disease course.

Patients and methods

Retrospective data from 152 pregnancies of 132 women with MS were collected by the physician in charge of the case. All data were entered into a specific file for qualitative and quantitative statistical analysis.

Results

From the total group of patients, 89 pregnancies occurred without any exposure to MS drugs, while 61 pregnancies occurred with at least eight weeks of exposure to MS immunomodulatory drugs. The rate of obstetric and neonatal complications was similar in both groups, except for the newborn weight and height which was smaller for mothers receiving medications. Mothers¡¯ post-delivery relapse rate and EDSS scores in the follow-up period were significantly higher in the absence of treatment.

Conclusion

It is possible that, with further such supportive data, international guidelines on MS treatment in young women who intend to get pregnant may need to be revised.