多发性硬化症患者的疾病调节药物和计划生育:海湾地区的共识

2020-06-23 Neurol Ther. 2020 Jun 20. doi: 10.1007/s40120-020-00201-8.

大多数疾病调节药物(DMDs)在怀孕期间都是禁忌的。对怀孕患者来说,多发性硬化症的管理尤其具有挑战性,因为停用DMDs会使患者面临疾病活动增加的风险。我们,一个来自阿拉伯海湾国家的多发性硬化症护理专家

中文标题:

多发性硬化症患者的疾病调节药物和计划生育:海湾地区的共识

发布机构:

发布日期:

2020-06-23

简要介绍:

大多数疾病调节药物(DMDs)在怀孕期间都是禁忌的。对怀孕患者来说,多发性硬化症的管理尤其具有挑战性,因为停用DMDs会使患者面临疾病活动增加的风险。我们,一个来自阿拉伯海湾国家的多发性硬化症护理专家小组,提出了我们对这些患者的多发性硬化症管理的共识建议。在可能的情况下,计划怀孕的患者可以改用在这种情况下认为安全的DMD。干扰素β现在可以在妊娠期间使用,在临床需要维持治疗的情况下,除了醋酸格拉替雷默外。那他利珠单抗(通常到妊娠30周,用于疾病活动度高、有复发和残疾进展风险的患者)也可持续到妊娠期。克拉利宾片和阿仑珠单抗被假设为免疫重建疗法(IRTs)。这些药物为许多患者提供了一段较长的免于复发的时间,但患者必须做好准备,在开始治疗后等待20个月才能怀孕。如果患者在服用fingolimod期间怀孕,并需要继续DMD治疗,可根据疾病活动程度,在可变的冲洗期后改用干扰素β或纳他珠单抗。应鼓励希望哺乳的妇女进行哺乳,哺乳期也可使用干扰素β。哺乳期使用其他DMDs的安全性尚缺乏数据。

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