Neuromyelitis Optica Spectrum Disorders and Pregnancy: Relapse-preventive Measures and Personalized Treatment Strategies

Overview

Journal EPMA J

Date 2018 Sep 4

PMID 30174761

Citations 15

Authors

Nadja Borisow

Kerstin Hellwig

Friedemann Paul

Affiliations

Soon will be listed here.

Abstract

Neuromyelitis optica spectrum disorders (NMOSD) are autoimmune inflammatory diseases of the central nervous system that predominately affect women. Some of these patients are of childbearing age at NMOSD onset. This study reviews, on the one hand, the role NMOSD play in fertility, pregnancy complications and pregnancy outcome, and on the other, the effect of pregnancy on NMOSD disease course and treatment options available during pregnancy. Animal studies show lower fertility rates in NMOSD; however, investigations into fertility in NMOSD patients are lacking. Pregnancies in NMOSD patients are associated with increased disease activity and more severe disability postpartum. Some studies found higher risks of pregnancy complications, e.g., miscarriages and preeclampsia. Acute relapses during pregnancy can be treated with methylprednisolone and/or plasma exchange/immunoadsorption. A decision to either stop or continue immunosuppressive therapy with azathioprine or rituximab during pregnancy should be evaluated carefully and factor in the patient's history of disease activity. To this end, involving neuroimmunological specialist centers in the treatment and care of pregnant NMOSD patients is recommended, particularly in specific situations like pregnancy.

Citing Articles

Pregnancy characteristics in Egyptian female patients with NMOSD.

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Advances in the long-term treatment of neuromyelitis optica spectrum disorder.

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[Pregnancy-associated neuromyelitis optical spectrum disorder combined with primary Sjögren's syndrome: A critical illness case report].

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Efficacy and safety of monoclonal antibodies in neuromyelitis optica spectrum disorders: A survival meta-analysis of randomized controlled trials.

Xu X, Xie L, Wei L, Li M, Wang H, Zhou H Adv Ophthalmol Pract Res. 2023; 2(3):100064.

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