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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2018; 76(06): 361-366
DOI: 10.1590/0004-282X20180041
ARTICLE

There is no benefit in the use of postnatal intravenous immunoglobulin for the prevention of relapses of multiple sclerosis: findings from a systematic review and meta-analysis

Não há benefício do uso de imunoglobulina endovenosa para prevenção de surtos na esclerose múltipla: achados de revisão sistemática e meta-análise
Gleysson Rodrigues Rosa
1   Harvard Medical School, Spaulding-Labuschagne Neuromodulation Center, Boston, USA;
,
Anthony Terrence O’Brien
1   Harvard Medical School, Spaulding-Labuschagne Neuromodulation Center, Boston, USA;
,
Eduardo de Almeida Guimarães Nogueira
2   Universidade Metropolitana de Santos, Departamento de Neurologia, Santos SP, Brasil.
,
Vitor Martinez de Carvalho
2   Universidade Metropolitana de Santos, Departamento de Neurologia, Santos SP, Brasil.
,
Sonia Castedo Paz
2   Universidade Metropolitana de Santos, Departamento de Neurologia, Santos SP, Brasil.
,
Yara Dadalti Fragoso
2   Universidade Metropolitana de Santos, Departamento de Neurologia, Santos SP, Brasil.
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ABSTRACT

Multiple sclerosis (MS) is a complex autoimmune and neurodegenerative disease of the central nervous system. Since MS affects mostly fertile women, pregnancy issues often arise in daily practice. The present study assessed the use of postpartum intravenous immunoglobulin (IVIG) in MS.

Methods The authors individually searched for records using PubMed, Medline, EMBASE, Cochrane, SciELO, LILACS, and Google Scholar, using the terms “multiple sclerosis” OR “MS” AND “pregnancy” OR “gestation” OR “partum” OR “post-partum” OR “puerperium” AND “immunoglobulin”.

Results The initial search returned 321 papers. There were 11 eligible articles selected for the review. In total, 380 patients had received post-natal IVIG to reduce the number of postpartum relapses. The unadjusted number needed to treat was 6.3 for the quantitative and 5.8 for the qualitative analyses.

Conclusion The therapeutic effect of IVIG for prevention of postnatal relapses in MS could not clearly be established in this meta-analysis.

RESUMO

Esclerose múltipla (EM) é uma complexa doença autoimune e neurodegenerativa do sistema nervoso central. Uma vez que EM afeta principalmente mulheres em idade fértil, assuntos relacionados à gravidez frequentemente surgem na prática diária. O presente estudo avaliou o uso pós-parto de imunoglobulina (IVIG) na EM.

Métodos Os autores individualmente pesquisaram as bases de dados PubMed, Medline, EMBASE, Cochrane, SciELO, LILACS, e Google Scholar usando os termos “multiple sclerosis” OR “MS” AND “pregnancy” OR “gestation” OR “partum” OR “post-partum” OR “puerperium” AND “immunoglobulin”.

Resultados A pesquisa inicial retornou 321 artigos. Havia 11 artigos elegíveis para a revisão. No total, havia relato de 380 pacientes que receberam IVIG após a gravidez visando reduzir o número de surtos. O número necessário para tratar não ajustado foi 6,3 para análise quantitativa e 5,8 para análise qualitativa.

Conclusão O efeito terapêutico da IVIG para prevenção dos surtos pós-parto na EM não pçde ser claramente estabelecida nesta meta-análise.

multiple sclerosis - pregnancy - immunoglobulins - Neurology - systematic review - meta-analysis
esclerose múltipla - gestação - imunoglobulinas - Neurologia - revisão sistemática - meta-análise


Publikationsverlauf

Eingereicht: 18. Januar 2018

Angenommen: 28. Februar 2018

Artikel online veröffentlicht:
25. August 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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