Pregnancy and the Postpartum Period in Women With Relapsing-Remitting Multiple Sclerosis Treated With Old and New Disease-Modifying Treatments: A Real-World Multicenter Experience
| Autor: | Francesco Patti, Aurora Zanghì, Luigi M.E. Grimaldi, Clara Grazia Chisari, Giovanna Borriello, Emanuele D'Amico, Graziella Callari |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pediatrics
medicine.medical_specialty Population new DMTs multiple sclerosis NEDA 3 lcsh:RC346-429 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Natalizumab Teriflunomide Medicine 030212 general & internal medicine Glatiramer acetate education lcsh:Neurology. Diseases of the nervous system Original Research Pregnancy education.field_of_study business.industry Multiple sclerosis medicine.disease Fingolimod Neurology chemistry old DMTs pregnancy Neurology (clinical) business 030217 neurology & neurosurgery Postpartum period medicine.drug |
| Zdroj: | Frontiers in Neurology, Vol 11 (2020) Frontiers in Neurology |
| ISSN: | 1664-2295 |
| DOI: | 10.3389/fneur.2020.00105 |
| Popis: | Introduction: Trends of disease activity during pregnancy, the postpartum period, and until 24 months from the delivery in the era of new drugs for the treatment of relapsing-remitting multiple sclerosis (RRMS) need to be investigated. Methods: In this cross-sectional Italian multicenter study, women with RRMS were included; the disease-modifying treatment (DMT) at the time of conception included were: interferons, glatiramer acetate, teriflunomide, dimethyl fumarate, fingolimod, and natalizumab. The main outcome of the study was to determine the rate of relapse occurrence during pregnancy and the postpartum period in all women grouped for each DMT. The secondary outcome was to determine the overall disease activity assessed by NEDA 3 (relapse, disability level, and radiological activity) at 24 months from the date of delivery. Results: Completed data were available for 81 pregnancies (in 74 women). Women on interferons and glatiramer had longer disease duration than women on dimethyl fumarate, fingolimod, and natalizumab (p < 0.05). Overall, we recorded 25 relapses during pregnancy (11 in 11 women) and the postpartum period (14 in 14 women). Natalizumab was the most commonly DMT in women (3) who experienced relapses during pregnancy. IFNs were the most commonly prescribed DMT in women (8) who experienced relapses during the postpartum period. At logistic regression analysis, specific treatment per se was not associated with relapse occurrence. No differences among the DMTs groups were recorded about NEDA 3 status at 24 months of follow-up. Conclusions: In our population, there was no difference in terms of relapses occurrence, disability status, and the overall disease activity during a follow up of 24 months. |
| Databáze: | OpenAIRE |
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