Natalizumab treatment and pregnancy in multiple sclerosis: A reappraisal of maternal and infant outcomes after 6 years.
Mult Scler
; 28(13): 2137-2141, 2022 Nov.
Article
em En
| MEDLINE
| ID: mdl-35296189
ABSTRACT
OBJECTIVES:
To assess the impact of timing of natalizumab cessation/redosing on long-term maternal and infant outcomes in 72 out of the original 74 pregnancies of the Italian Pregnancy Dataset in multiple sclerosis (MS).METHODS:
Maternal outcomes in patients who received natalizumab until conception and restarted the drug within 1 month after delivery ("treatment approach," (TA)) and patients who stopped natalizumab before conception and/or restarted the drug later than 1 month after delivery ("conservative approach," (CA)) were compared through multivariable Cox regression analyses. Pediatric outcomes were assessed through a semi-structured questionnaire.RESULTS:
After a mean follow-up of 6.1 years, CA (hazard ratio (HR) = 4.1, 95% CI 1.6-10.6, p = 0.003) was the only predictor of relapse occurrence. Worsening on the Expanded Disability Status Scale (EDSS) was associated with higher annualized relapse-rate during the follow-up (HR = 3.3, 95% CI 1.4-7.9 p = 0.007). We found no major development abnormalities in children.DISCUSSION:
Our data confirm that TA reduces the risk of disease activity; we did not observe an increase in major development abnormalities in the child.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Esclerose Múltipla Recidivante-Remitente
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Esclerose Múltipla
Tipo de estudo:
Prognostic_studies
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Qualitative_research
Limite:
Child
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Female
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Humans
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Infant
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Pregnancy
Idioma:
En
Revista:
Mult Scler
Assunto da revista:
NEUROLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Itália