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#Post#: 773--------------------------------------------------
(AAN) Pregnancy doesn't prevent MS reactivation after stopping T
ysabri...
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 χ2
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
[/quote]
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