A new study has revealed several complications of a multiple sclerosis treatment. The studies illuminate difficulties surrounding a powerful drug treatment and potential pregnancies. Keep reading to learn more about the dilemmas of treatment, or follow the original story here.
Both studies investigate the drug Tysabri, or natalizumab. The first study focuses on the likelihood of multiple sclerosis relapse. It shows that patients who cease treatment with the drug before conceiving are more likely to experience a relapse of multiple sclerosis than those who do not.
The second study creates the really difficult decision. Multiple sclerosis is debilitating, and ceasing treatment makes it more likely to return. Continuing treatment, however, carries risks for the child. The second study reveals that if a woman continues treatment with Tysabri while attempting to conceive, it could affect the health of her unborn baby.
Researchers in Italy found that exposure to Tysabri up to 12 weeks of gestation correlated with a greater incidence of miscarriage. Research also showed that the average length and weight of babies exposed to the drug while in the womb was unusually.
“Our findings suggest that if women who take natalizumab for MS want to become pregnant, it may be best to continue treatment up until a pregnancy test is positive and then at that point discontinue use,” says lead researcher Dr. Emilio Portaccio.
Another researcher carefully indicated that this course of treatment is not foolproof. Multiple sclerosis may not be staved off entirely by this method. It does, however, decrease the likelihood of relapse.
Other experts in the multiple sclerosis field are less persuaded by these results.
They say this study simply means more research needs to be done. Kathy Costello, associate vice president of health care access for the National MS Society, for example, says decisions ought not be based on the results of a single study.
Tysabri helps to battle the autoimmune qualities of multiple sclerosis. Normally immune cells protect the body but in cases of multiple sclerosis, they attack what they should defend. Tysabri keep those immune cells locked in the blood stream, unable to reach the central nervous system. Tysabri is often prescribed when other treatments have been unsuccessful.
Pregnancy also seems to provide a sort of natural treatment for multiple sclerosis symptoms. It is suspected that this is a result of the immune system scaling back to avoid harming the fetus. Multiple sclerosis can return, however, after delivery if the patient has ceased treatment. Often times it comes back with even greater severity.
Given the results of other studies which have linked Tysabri to issues during pregnancy, many regulatory bodies have suggested that treatment be suspended for a minimum of three months prior to conception.
Researchers looking at data from this most recent study remain apprehensive. It’s a difficult choice. Stopping treatment carries notable risks for the mothers. Continuing treatment, meanwhile, may impact the health of the baby. The results may also be different for different patients, depending on the severity of their disease.
The bottom line is that researchers are advising caution and careful planning. A lot of the decision making comes down to a patient’s medical history.
“I don’t think we can say every woman with MS should continue natalizumab up to pregnancy in an absolute way,” says Dr. Ruth Ann Marrie, director of the Multiple Sclerosis Clinic at the University of Manitoba. “If you’re thinking about pregnancy, let’s plan it and talk about what the pros and cons are for you.”
