Pregnancy, MS and IV Ig

Q.  I just read about some neurologists having their pregnant patients, that just discontinued Tysabri, on IV Ig throughout pregnancy to avoid rebound relapses. What's your opinion on this? Thank you!

A.  For pregnancy, neurologists take many approaches to prevent Tysabri withdrawal relapses. I previously discussed in another blog tapering off Tysabri and monitoring for the return of disease activity before getting pregnant. I cannot argue with the use of IV Ig in this situation as well but recall that IV Ig treatment itself is controversial in MS patients. The majority of studies suggest minimal benefit from this treatment, so I would not expect it to have much of a benefit in this situation. However, it is relatively safe in this situation and I think it is the safety of IV Ig that is dictating its use in this setting, not its effectiveness.

--Dr. Kinkel

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