Tom 12, Nr 3 (2016)
Artykuł przeglądowy
Opublikowany online: 2016-12-02
Wyświetlenia strony
1191
Wyświetlenia/pobrania artykułu
14872
Leki immunomodulacyjne a ciąża w stwardnieniu rozsianym
Pol. Przegl. Neurol 2016;12(3):146-156.
Streszczenie
Stwardnienie rozsiane częściej występuje u kobiet, a szczyt zachorowań przypada na wiek rozrodczy. Dlatego zagadnienie ciąży w stwardnieniu rozsianym jest szczególnie ważnym tematem. Leczenie immunomodulujące, które hamuje przebieg stwardnienia rozsianego, może wpływać na planowanie ciąży, koncepcję, samą ciążę oraz płód. W ostatnich latach opublikowano kilka analiz dotyczących tego problemu, a uzyskane dane zmieniają ocenę bezpieczeństwa terapii immunomodulacyjnej u pacjentek, które planują ciążę lub są w ciąży. Leki I linii mają wysoki profil bezpieczeństwa stosowania u kobiet w wieku rozrodczym zarówno pod względem ich wpływu na sam przebieg ciąży, jak i na dziecko. Leki II linii są mniej bezpieczne, jednak również nie zwiększają istotnie ryzyka wystąpienia wad wrodzonych u dziecka. Natomiast dane na temat ich wpływu na sam przebieg ciąży są niewystarczające. Trwają obserwacje najnowszych leków odnośnie do ciąży, ale obecne dane nie pozwalają jeszcze ostatecznie określić ich wpływu na ciążę i płód. Mimo wzrostu obserwacji o bezpieczeństwie terapii immunomodulacyjnej u chorych na stwardnienie rozsiane decyzje dotyczące stosowanego leczenia zawsze powinny uwzględniać
poczęcie i ciążę.
Słowa kluczowe: stwardnienie rozsianeciąża wysokiego ryzykaimmunomodulacjawady wrodzone
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