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Neurology:那他珠单抗治疗的多发性硬化症妇女妊娠决策-胎儿风险!

2018-02-08 xing.T MedSci原创

由此可见,该研究结果显示,妊娠12周以后暴露于那他珠单抗与SA风险增加有关,尽管处于一般人群的预期范围内,而CA的风险需要进一步研究。考虑到那他珠单抗混悬液引起疾病复发的高风险,可以计划继续使用那他珠单抗治疗,同时严格监测受孕情况。

近日,神经病学领域权威取杂志Neurology上发表了一篇研究文章,研究人员旨在评估多发性硬化(MS)妇女妊娠期间接受那他珠单抗治疗后的胎儿风险,特别是自然流产(SA)和先天性异常(CA)。

研究人员收集了2009年至2015年期间19个参与地区所有接受那他珠单抗治疗的所有MS女性妊娠数据,并与未经治疗的MS患者和注射免疫调节剂治疗的患者进行比较。SA和CA的发生率也与意大利人群报告的数据进行比较。研究人员采用多变量logistic和线性回归模型进行分析。

该研究共纳入了83名妇女,共进行了92次妊娠。在多变量分析中,那他珠单抗暴露与SA相关(比值比[OR]为3.9,95%可信区间[CI]为1.9-8.5,P<0.001)。但是,SA(17.4%)以及主要CA(3.7%)的发生率处于总人群的估计值范围内。此外,暴露于那他珠单抗和干扰素-β(IFN-β)与婴儿的身长和体重较低有关(P<0.001)。

由此可见,该研究结果显示,妊娠12周以后暴露于那他珠单抗与SA风险增加有关,尽管处于一般人群的预期范围内,而CA的风险需要进一步研究。考虑到那他珠单抗混悬液引起疾病复发的高风险,可以计划继续使用那他珠单抗治疗,同时严格监测受孕情况。

该研究提供了III类证据表明与接受IFN-β治疗或未治疗的患者相比,接受那他珠单抗治疗的女性患者自然流产风险增加(比值比为3.9,95%可信区间为1.9-8.5)。

原始出处:


Emilio Portaccio,et al. Pregnancy decision-making in women with multiple sclerosis treated with natalizumab I: Fetal risks.Neurology. 2018. https://doi.org/10.1212/WNL.0000000000005067

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    2018-07-23 yinhl1978
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    2018-04-01 jml2009
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