Trimesta is a branded formulation of Estriol, an estrogen produced in large quantities during pregnancy. It is believed that production of Estriol during pregnancy may be one reason for the decrease in MS disease activity noted in MS patients during the later stages of pregnancy. There are preliminary studies suggesting possible benefits of Estriol in MS, but these studies are far from conclusive. Estriol is not currently marketed for any indication in the united states so it is not even available off label. I am not aware of any phase III trials in progress so the path forward for approval of Estriol in the United States is unclear at this time.
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