b"Medicine & Research Doctors NotesThe MS News column includes analysis from BenThrower, M.D., MS Focus senior medical advisor. He drawsfrom the top news stories of the quarter and explainswhat the news means to you, the person with MS.Christine Willis, MLIS, AHIP, is the Clinical InformationLibrarian at Children's Healthcare of Atlanta, EglestonHospital.Pregnancy may delay onset of CISrandomized, double-blind, double-dummy,Researchers in Australia and Czech Republic active-controlled clinical trials of identicalcollected data from female patients in four design to assess the ecacy and safety ofhospitaloutpatientclinicsforreview.The subcutaneous ofatumumab compared withstudy participants were older than 18 years, oral teriunomide. These international trialshad a clinically isolated syndrome onset date,known as ASCLEPIOS I and IIwereand consented to specic medical record re- conducted over a period of nearly two yearsview.Atotalof2557womenparticipated with 1882 patients. The primary end pointwith a mean age of 31.9 years, almost half of was to assess if ofatumumab would decreasewhom had at least one pregnancy. After data relapses.Therewerethreeadditionalendanalysis the researchers found the time to points evaluated regarding disability, MRI,CIS onset was delayed by 3.3 years in women and biomarkers. These end points did notwith previous pregnancies and 3.4 years in show signicant worsening of MS symptoms.womenwithpreviouschildbirths.Having Adverse events, infections, and injection-morepregnanciesorchildbirthswasnot related reactions were noted and no seriouslinked to later CIS onset. This study gives ad- events were reported. Utilizing this evidenceditionaldatatoconsiderpregnancymay to share that the relapse rate is signicantlydelay CIS onset. lower with ofatumumab, Novartis PharmaDr. ThrowerThese researchers looked at how wasabletoobtainFDAapprovaltobeginthe age of onset of women with a CIS was using this drug.aected by whether they had ever been pregnant. Dr. ThrowerMore options for treating MSWomen who had been pregnant in the past are always welcome. In recent years, therehad a later age of onset of their CIS. We have has been an explosion of interest in the roleknownfordecadesthatpregnancyhasa of B-cells in MS. For decades, T-cells seemedcalming eect on MS, possibly through an to get all the attention. B-cells have two primaryestrogen called estriol. This study would add roles in the human immune system. Theyto that knowledge and suggests pregnancy mature into plasma cells and produce antibodies.may also delay the development of MS. In addition, B-cells may help coordinate theFDA approves use of Ofatumumabfunction of T-cells through antigen presentation.Four drugs are used in MS that work throughNovartis Pharma sponsored two phase 3, B-cellpathways,rituximab(Rituxanandmsfocusmagazine.org 54"