Use of disease-modifying drugs during pregnancy and breastfeeding

Purpose of review The fact that multiple sclerosis (MS) predominantly affects women has been recognized for many years. As the age at diagnosis is decreasing, and treatment options are becoming more complex, increasing numbers of women are facing decisions about the use of disease modifying therapy (DMT) in and around pregnancy. Recent findings New data are rapidly becoming available, particularly regarding the safety of therapies in both pregnancy and breastfeeding. Effective treatment and suppression of relapses is key to ensuring good outcomes in the longer term for the woman, however this must be balanced against individual risk of relapse and risks to the fetus. Women should be advised that it is possible to breastfeed while taking selected DMT. In this review, we discuss evidence surrounding the safety of DMTs in both pregnancy and breastfeeding, and use this knowledge to suggest approaches to pregnancy and family planning in women with MS.

Automated summary

MS predominantly affects women, with decreasing age at diagnosis and complex treatment options, more women are facing decisions about disease modifying therapy during and around pregnancy. New data on the safety of therapies during pregnancy and breastfeeding are emerging rapidly. Effective treatment and suppression of relapses is crucial for ensuring good outcomes in the longer term for women.