b"Doctors NotesThe MS News column includes analysis from Ben Thrower, M.D., MS Focus senior medical advisor. He draws from the top news stories of the quarter and explains what the news means to you, the person with MS. Christine Willis, MLIS, AHIP, is the Clinical Information Librarian at Children's Healthcare of Atlanta, Egleston Hospital. Natalizumab data increasesevery 28 days for relapsing forms of MS. pregnancy optionsTypically, we think about discontinuing a Researchers in Spain conducted anwomans MS disease-modifying therapy prior observational retrospective study that includedto her trying to get pregnant. This decision six pregnant women with highly active multiplemust be balanced with the risk for her MS sclerosis being treated with natalizumab. Theworsening while off therapy. This study would women were put on the NAP-30 protocol tosupport another option; continuing natalizumab have natalizumab administered every six weeksthrough pregnancy without interruption. This afterappropriatescheduleadjustments.was a small observational report with only six Natalizumab was given on this schedule upwomen. Other studies have looked at larger until the 30th week of pregnancy with deliveriesnumbers of women and have also found scheduled at week 40. No relapses were reportednatalizumab to be safe for use through the third during pregnancy or within six months post- trimester. The drug does appear to cross the partum. All but one infant was born early atplacenta and can be found in the bloodstream 35 weeks with some complications thatof the baby. Some babies have had transient resolved shortly and the others each hadlow red blood cell or platelet counts. Guidelines normal birth weight and showed no bloodfrom the Association of British Neurologists count abnormalities. The authors acknowledgerecommend maintaining Tysabri up to this is a small sample size for a study andapproximately 34 weeks of gestation and further research is necessary for adequaterestarting treatment soon after birth to mitigate statistical analysis to determine efficacy andthe risk of rebound disease activity. Those safety for any clinical recommendations.guidelines recommend treatment be restarted within eight to 12 weeks after the Dr. Thrower: Many people living with MS arelast dose predelivery. So, there are a lot of women of child-bearing age who want to startoptions to discuss with your MS healthcare team families. This decision requires a discussionif you are a woman with MS on natalizumab of the risks of MS therapies to the baby versusand are planning a pregnancy.the risk to the mother of stopping the therapy.Study: Caffeine may be benecial Fortunately, we have data on the safety of many MS therapies before and during pregnancy toTwelve participants from the North Bristol help guide us. Natalizumab (Tysabri) is a highlyNHS Trusts MS service were enrolled in a effective monoclonal antibody administeredsingle-blind, crossover trial to evaluate the 51 msfocusmagazine.org"