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       #Post#: 773--------------------------------------------------
       (AAN) Pregnancy doesn't prevent MS reactivation after stopping
       Tysabri...
   DIR By: agate
       Date: May 7, 2015, 2:51 pm
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       Presented at the recent annual AAN conference in Washington, DC:
       --- Quote ---
       > [S20.003] Pregnancy does not prevent disease re-activation
       after natalizumab suspension in patients with multiple sclerosis
       >
       > Maria Amato,1Bahia Hakiki,2Luisa Pastò,2Marta
       Giannini,2Lorenzo Razzolini,2Carla Tortorella,3Mariangela
       D'Onghia,4Maria Trojano,4Eleonora Cocco,5Marta Melis,5Maria
       Marrosu,6Valeria Di Tommaso,7Deborah Farina,7Alessandra
       Lugaresi,8Pietro Annovazzi,8Angelo Ghezzi,9Claudio
       Gasperini,10Alfonso Iudice,9Roberta Fantozzi,9Paolo
       Bellantonio,11Silvia Messina,12Francesco Patti,12Silvia
       Masera,13Paola Cavalla,9Alessandra Protti,6Maria Rossi,14Rocco
       Totaro,14Laura De Giglio,9Carlo Pozzilli,10Emilio Portaccio,2MS
       Study Group of the Italian Neurological Society
       >
       > 1Firenze, Italy, 2Florence, Italy, 3Nampoli, Italy, 4Bari,
       Italy, 5Cagliari, Italy, 6Milano, Italy, 7Chieti, Italy, 8Milan,
       Italy, 9Italy, 10Rome, Italy, 11Pozzilli, Italy, 12Catania,
       Italy, 13Torino, Italy, 14L'Aquila, Italy.
       >
       > Objective:
       >
       > To assess multiple sclerosis (MS) disease activity during
       pregnancy after natalizumab exposure (NE) and the impact of
       natalizumab exposure (NE) on pregnancy outcomes.
       >
       > Background:
       >
       > While the risk of disease re-activation after natalizumab
       suspension is widely acknowledged, little is known on disease
       activity during pregnancy occurring after suspension of
       natalizumab in MS patients. In hypothesis, since gestational
       period is related to a reduction [in the] relapse-rate, a
       “protection” from disease re-activation could be expected.
       >
       > Design/Methods:
       >
       > We recruited NE pregnancies in MS patients prospectively
       followed-up in 13 Italian MS Centres, in the period 2010-2013.
       Exposure to natalizumab was defined as suspension of the drug <
       ten weeks prior to conception. Clinical relapses and pregnancy
       outcomes during pregnancy were compared with data from the
       Italian dataset on interferon-beta exposed (IFNBE) pregnancies
       (Amato et al., 2010). All the patients were administered a
       structured interview which gathered detailed information on
       pregnancy course and outcomes, as well as on possible
       confounders. Group comparisons were assessed through the &#967;2
       test, the analysis of variance and a mixed factorial design,
       when appropriate.
       >
       > Results:
       >
       > So far 32 pregnancies were recruited. Pregnancies resulted in
       25 live births, six spontaneous abortions and two voluntary
       abortions (one due to Down Syndrome). The occurrence of relapses
       during pregnancy in 9/25 (36%) patients was higher that observed
       in IFNBE patients (10/75, 13.3%; mixed factorial design
       F=2.668,p=0.003). Proportion of spontaneous abortion in NE
       pregnancies (18.8%) was not significantly different from that
       previously observed in IFNBE pregnancies (8%;p=0.106).
       >
       > Proportions of pre-term deliveries (20%), mean birth-weight
       (2907gr) and birth-length (49.3cm) were also comparable to those
       of IFNBE pregnancies (p>0.3).
       >
       > Conclusions:
       >
       > In our study pregnancy did not protect from disease
       re-activation after natalizumab suspension in MS patients. The
       risk of relapses during pregnancy should be taken into account
       in the counselling of natalizumab-treated MS patients
       contemplating pregnancy.
       >
       > _________________
       > Category - MS and CNS Inflammatory Disease: Clinical Science
       >
       > Session: S20: Platform Session: Treatment Mechanisms in
       Multiple Sclerosis (2:00 PM-3:45 PM)
       > Date/Time: Wednesday, April 22, 2015 - 2:30 pm
       >
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