Introduction

Cladribine is an oral immune reconstitution therapy for relapsing multiple sclerosis (RMS). Hormonal and immune changes are responsible for the decline of disease activity in the third trimester of pregnancy and disease reactivation in the early post-partum period.We investigate the impact of pregnancy on disease activity in women with MS who conceived after cladribine treatment.

Methods

We recruited women of childbearing age with relapsing–remitting MS (RRMS) who became pregnant or not after being treated with cladribine. For both groups, demographic, clinical and radiological data were collected 1 year before and after treatment during a mean follow-up of 3.53 years. We compared disease activity over time between groups using variance analysis for repeated measures.

Results

48 childbearing women were included. 25 women had a pregnancy after a mean of 1.75 years from the first treatment cycle. Women with or without pregnancy did not differ in demographics or pre-cladribine disease activity. No significant differences in disease activity or EDSS worsening were found between women with or without pregnancy.

Discussion

Our findings suggest that pregnancy does not appear to influence disease activity and disability in women previously treated with cladribine; further studies with larger numbers and longer follow-up are needed to confirm this finding.

中文翻译：

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妊娠对接受克拉屈滨治疗的多发性硬化症女性疾病活动度的影响

介绍

拉屈滨是一种口服免疫重建疗法，用于治疗复发性多发性硬化症 (RMS)。激素和免疫变化是导致妊娠晚期疾病活动性下降和产后早期疾病重新激活的原因。我们研究了妊娠对接受克拉屈滨治疗后怀孕的多发性硬化症女性疾病活动性的影响。

方法

我们招募了患有复发缓解型多发性硬化症（RRMS）的育龄女性，她们在接受克拉屈滨治疗后怀孕或未怀孕。对于两组，在治疗前后 1 年收集人口统计学、临床和放射学数据，平均随访时间为 3.53 年。我们使用重复测量的方差分析比较了各组之间疾病随时间的活动情况。

结果

其中包括 48 名育龄妇女。 25 名女性在第一个治疗周期平均 1.75 年后怀孕。怀孕或未怀孕的女性在人口统计学或克拉屈滨前疾病活动方面没有差异。怀孕或未怀孕的女性在疾病活动度或 EDSS 恶化方面没有发现显着差异。

讨论

我们的研究结果表明，怀孕似乎不会影响先前接受克拉屈滨治疗的女性的疾病活动和残疾；需要更多的研究和更长时间的随访来证实这一发现。