: Multiple sclerosis is often diagnosed in patients who are planning on having children. Although multiple sclerosis does not negatively influence most pregnancy outcomes, less is known regarding the effects of fetal exposure to novel disease-modifying therapies (DMTs). The withdrawal of some DMTs during pregnancy can modify the natural history of multiple sclerosis, resulting in a substantial risk of pregnancy-related relapse and disability. Drug labels are typically restrictive and favour fetal safety over maternal safety. Emerging data reporting outcomes in neonates exposed to DMTs in utero and through breastfeeding will allow for more careful and individualised treatment decisions. This emerging research is particularly important to guide decision making in women with high disease activity or who are treated with DMTs associated with risk of discontinuation rebound. As increasing data are generated in this field, periodic updates will be required to provide the most up to date guidance on how best to achieve multiple sclerosis stability during pregnancy and post partum, balanced with fetal and newborn safety.

Family planning considerations in people with multiple sclerosis / Krysko, Kristen M; Dobson, Ruth; Alroughani, Raed; Amato, Maria Pia; Bove, Riley; Ciplea, Andrea I; Fragoso, Yara; Houtchens, Maria; Jokubaitis, Vilija G; Magyari, Melinda; Abdelnasser, Azza; Padma, Vasantha; Thiel, Sandra; Tintore, Mar; Vukusic, Sandra; Hellwig, Kerstin. - In: LANCET NEUROLOGY. - ISSN 1474-4422. - ELETTRONICO. - 22:(2023), pp. 350-366. [10.1016/S1474-4422(22)00426-4]

Family planning considerations in people with multiple sclerosis

Amato, Maria Pia;
2023

Abstract

: Multiple sclerosis is often diagnosed in patients who are planning on having children. Although multiple sclerosis does not negatively influence most pregnancy outcomes, less is known regarding the effects of fetal exposure to novel disease-modifying therapies (DMTs). The withdrawal of some DMTs during pregnancy can modify the natural history of multiple sclerosis, resulting in a substantial risk of pregnancy-related relapse and disability. Drug labels are typically restrictive and favour fetal safety over maternal safety. Emerging data reporting outcomes in neonates exposed to DMTs in utero and through breastfeeding will allow for more careful and individualised treatment decisions. This emerging research is particularly important to guide decision making in women with high disease activity or who are treated with DMTs associated with risk of discontinuation rebound. As increasing data are generated in this field, periodic updates will be required to provide the most up to date guidance on how best to achieve multiple sclerosis stability during pregnancy and post partum, balanced with fetal and newborn safety.
2023
22
350
366
Goal 3: Good health and well-being
Krysko, Kristen M; Dobson, Ruth; Alroughani, Raed; Amato, Maria Pia; Bove, Riley; Ciplea, Andrea I; Fragoso, Yara; Houtchens, Maria; Jokubaitis, Vilija G; Magyari, Melinda; Abdelnasser, Azza; Padma, Vasantha; Thiel, Sandra; Tintore, Mar; Vukusic, Sandra; Hellwig, Kerstin
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1301980
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