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Postpartum Steroids Reduce Multiple Sclerosis Relapses

(Posted By: Josi Creek)

 A single dose of methylprednisolone given to new mothers with multiple sclerosis immediately after delivery reduced the risk of relapse for up to three months, researchers found.


During the first postpartum trimester, relapses occurred in 18% of new mothers who received 1 g of intravenous methylprednisolone compared with 46% of those not receiving treatment (P=0.0448), according to data presented here at the meeting of the Joint Consortium of Multiple Sclerosis Centers and America's Committee on Treatment and Research in Multiple Sclerosis.


In the following six months, there was no difference in the relapse rates between the two groups, Jose Avila, MD, of the Maxine Mesinger MS Comprehensive Clinic at Baylor College of Medicine in Houston, reported.
Preliminary work from other centers has suggested that IV methylprednisolone might be effective in reducing the relapse rate after birth. Avila's group had been using this treatment in many new mothers at their clinic and so performed a retrospective analysis of their outcomes to further understand its potential.

The researchers examined 50 patients with relapsing-remitting MS and two with primary progressive disease. Of those, 39 had received steroid treatment immediately after giving birth, and 13 had not. The mean ages of the women were the same in each group, as was the mean disability score. Both groups had similar relapse rates in the year before pregnancy, and each group contained one patient with the primary progressive form of the disease.

The results of the trial suggest that IV methylprednisolone immediately postpartum may be an important treatment option for women with MS, Avila said, although larger and prospective trials are needed first.
He also indicated that a second dose of methylprednisolone may be worth investigating, to determine if it can reduce relapse rate later into the postpartum period.

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