| Disease-modifying drugs for multiple sclerosis in pregnancy: a systematic review. | |
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MedLine Citation:
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PMID: 22933738 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To systematically review the literature regarding safety of disease-modifying drug (DMD) use during pregnancy on perinatal and developmental outcomes in offspring of patients with multiple sclerosis (MS). METHODS: A PubMed and EMBASE search up to February 2012 was conducted with a manual search of references from relevant articles. Selected studies were evaluated using internationally accepted criteria. RESULTS: Fifteen studies identified 761 interferon β-, 97 glatiramer acetate-, and 35 natalizumab-exposed pregnancies. Study quality ranged from poor to good; no study was rated excellent. Small sample sizes limited most studies. Compared with data for unexposed pregnancies, fair- to good-quality prospective cohort studies reported that interferon β exposure was associated with lower mean birth weight, shorter mean birth length, and preterm birth (<37 weeks), but not low birth weight (<2,500 g), cesarean delivery, congenital anomaly (including malformation), or spontaneous abortion. Fewer studies of fair quality were available for glatiramer acetate and natalizumab. Glatiramer acetate exposure was not associated with lower mean birth weight, congenital anomaly, preterm birth, or spontaneous abortion. Natalizumab exposure did not appear to be associated with shorter mean birth length, lower mean birth weight, or lower mean gestational age. No studies examined mitoxantrone or fingolimod exposure. One study of paternal DMD use during conception found no effect on gestational age or birth weight. Few studies examined longer-term developmental outcomes. CONCLUSION: Further studies are needed to determine the potential risks associated with preconceptional and in utero DMD exposure in patients with MS. Discontinuation of DMDs before conception is still recommended. |
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Authors:
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Ellen Lu; Bing Wei Wang; Colleen Guimond; Anne Synnes; Dessa Sadovnick; Helen Tremlett |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review Date: 2012-08-29 |
Journal Detail:
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Title: Neurology Volume: 79 ISSN: 1526-632X ISO Abbreviation: Neurology Publication Date: 2012 Sep |
Date Detail:
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Created Date: 2012-09-11 Completed Date: 2012-12-04 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 0401060 Medline TA: Neurology Country: United States |
Other Details:
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Languages: eng Pagination: 1130-5 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Antibodies, Monoclonal, Humanized
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adverse effects*,
therapeutic use Female Humans Immunologic Factors / adverse effects*, therapeutic use Interferon-beta / adverse effects*, therapeutic use Multiple Sclerosis / drug therapy* Peptides / adverse effects*, therapeutic use Pregnancy Pregnancy Complications / drug therapy* |
| Grant Support | |
ID/Acronym/Agency:
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//Canadian Institutes of Health Research |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Monoclonal, Humanized; 0/Immunologic Factors; 0/Peptides; 0/copolymer 1; 0/natalizumab; 77238-31-4/Interferon-beta |
| Comments/Corrections | |
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