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
in 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.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Multiple Sclerosis, Relapsing-Remitting
/
Multiple Sclerosis
Type of study:
Prognostic_studies
/
Qualitative_research
Limits:
Child
/
Female
/
Humans
/
Infant
/
Pregnancy
Language:
En
Journal:
Mult Scler
Journal subject:
NEUROLOGIA
Year:
2022
Document type:
Article
Affiliation country:
Italy