Sunday, April 22, 2007

Interferon beta babies-- Pregnancy on MS treatment

Two articles and editorial. editorial by Waubant E and Sadovnick AD. Neurology 2005; 65:788-789. Articles in same issue editorialized are Sandberg-Wollheim M et al. Pregnancy outcomes during treatment with interferon beta-1a in patients with multiple sclerosis. Neurology 2005; 65:802-806. Boskovic R et al. The reproductive effects of beta interferon therapy in pregnancy: a longitudinal cohort. Neurology 2005; 65: 807-811.

DMT's (Disease modifying therapy) are abortifacient in monkeys, but not known to be so in humans. The first article showed that looking at the published literature cumulatively, patients on interferon do not have trouble getting pregnant. Pregnancy outcomes, defined by pregnancy loss and congenital malformations, were not different compared to placebo. The rate of miscarriage was at the upper limit of normal expected range. The numbers are reassuring and similar to those derived from glatiramer acetate. The women studied may not be representative since they were on clinical trials.

The Boscovic article compares people with MS who conceived on interferon DMT, who conceived after stopping interferons and healthy controls. There was a slight increased risk of miscarriage (spontaneous abortion) and smaller birth weight babies in those conceived while on DMT. There also was a suggestion that the rate of malformation might be higher.

The editorialist writes that "prudence suggests the discontinuation of IFN-1A and any DMT prior to initiating pregnancy whould remain the rule whenever possible."

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