Estriol plus Glatiramer Acetate for Women with Relapsing–Remitting Multiple Sclerosis

Patients with multiple sclerosis (MS) who become pregnant experience a significant decrease in relapses, as much as 70% during the last trimester. This benefit may be mediated by a shift in immune responses from T helper 1 to T helper 2. Relapses decrease at the same time that the hormone estriol is increased during pregnancy. Estriol is an estrogen made by the fetal-placental unit that is not present at appreciable amount in nonpregnant women; its anti-inflammatory and neuroprotective effects have been seen in preclinical studies.

This double-blind, placebo-controlled, randomized trial was conducted at 16 U.S. academic neurology centers. One hundred sixty-four women aged 18 to 50 years with relapsing–remitting MS were randomly assigned (1:1…