A Report of Multiple Sclerosis Registry in Mazandaran Province 2019-2021

Background and purpose: Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system. The purpose of this study was to report the information of MS patients registered in Mazandaran MS Registry System between 2019 and 2021. Materials and methods: This retrospective study was performed in patients with MS living in Mazandaran province using the MS national registry system in Iran. Results: A total of 2211 patients were found, including 72.8% females and the mean age of patients was 36.97±9.47 years. Most of the patients had Relapsing remitting (RR) MS (61.2%) followed by Secondary progressive (SP) MS (19.6%) and a family history of the disease was seen in 16.2%. Most of the patients lived in populated cities; Sari and Amol. Interferons, Rituximab, and Fingolimod were found to be the most widely used drugs. The mean score for Expanded Disability Status Scale (EDSS) was higher in men than women. The mean EDSS scores were the lowest in clinically isolated syndrome (CIS) type of the disease and the highest in the SP and RP types. The level of disability was significantly higher in men than women (P<0.001). Conclusion: The types of MS in Mazandaran province is similar to global data of this disease, but the increasing prevalence of familial MS in this province compared with other provinces requires more detailed studies

Pregnancy and the Use of Disease-Modifying Therapies in Patients with Multiple Sclerosis: Benefits versus Risks

The burden of multiple sclerosis (MS) in women of childbearing potential is increasing, with peak incidence around the age of 30 years, increasing incidence and prevalence, and growing female : male ratio. Guidelines recommend early use of disease-modifying therapies (DMTs), which are contraindicated or recommended with considerable caution, during pregnancy/breastfeeding. Many physicians are reluctant to prescribe them for a woman who is/is planning to be pregnant. Interferons are not absolutely contraindicated during pregnancy, since interferon-beta. appears to lack serious adverse effects in pregnancy, despite a warning in its labelling concerning risk of spontaneous abortion. Glatiramer acetate, natalizumab, and alemtuzumab also may not induce adverse pregnancy outcomes, although natalizumab may induce haematologic abnormalities in newborns. An accelerated elimination procedure is needed for teriflunomide if pregnancy occurs on treatment or if pregnancy is planned. Current evidence supports the contraindication for fingolimod during pregnancy; data on other DMTs remains limited. Increased relapse rates following withdrawal of some DMTs in pregnancy are concerning and require further research. The postpartum period brings increased risk of disease reactivation that needs to be carefully addressed through effective communication between treating physicians and mothers intending to breastfeed. We address the potential for use of the first-and second-line DMTs in pregnancy and lactation

Pregnancy And The Use Of Disease-Modifying Therapies In Patients With Multiple Sclerosis: Benefits Versus Risks

The burden of multiple sclerosis (MS) in women of childbearing potential is increasing, with peak incidence around the age of 30 years, increasing incidence and prevalence, and growing female : male ratio. Guidelines recommend early use of disease-modifying therapies (DMTs), which are contraindicated or recommended with considerable caution, during pregnancy/breastfeeding. Many physicians are reluctant to prescribe them for a woman who is/is planning to be pregnant. Interferons are not absolutely contraindicated during pregnancy, since interferon-β appears to lack serious adverse effects in pregnancy, despite a warning in its labelling concerning risk of spontaneous abortion. Glatiramer acetate, natalizumab, and alemtuzumab also may not induce adverse pregnancy outcomes, although natalizumab may induce haematologic abnormalities in newborns. An accelerated elimination procedure is needed for teriflunomide if pregnancy occurs on treatment or if pregnancy is planned. Current evidence supports the contraindication for fingolimod during pregnancy; data on other DMTs remains limited. Increased relapse rates following withdrawal of some DMTs in pregnancy are concerning and require further research. The postpartum period brings increased risk of disease reactivation that needs to be carefully addressed through effective communication between treating physicians and mothers intending to breastfeed. We address the potential for use of the first- and second-line DMTs in pregnancy and lactation.PubMe