What is the role of IV immunoglobulin in the treatment of postpartum multiple sclerosis?

Updated: Nov 08, 2018
  • Author: Carmel Armon, MD, MSc, MHS; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

Answer

IVIg treatment may be effective in reducing the incidence of pregnancy- and postpartum-related relapses. Again, the potential risks and benefits must be carefully assessed before treatment is started, especially because the medication falls into category C. Its safety in breastfeeding women is unknown.

In a study of 9 patients with a history of postpartum acute exacerbations of MS who were treated with IVIg for 5 consecutive days in the first week after childbirth and at 6 and 12 weeks afterward, none had a relapse during the 6 months after delivery. [56]

Achiron et al retrospectively studied IVIg treatment during pregnancy and the postpartum period in 108 pregnant patients with relapsing-remitting MS and found a positive effect. [57] The subjects were assigned to an untreated group, a group treated with IVIg in the first week after delivery with booster doses after 6 and 12 weeks, or another group treated continuously with IVIg during and after pregnancy.


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