Multiple sclerosis (MS) experts in the United Kingdom have proposed consensus guidelines for the management and treatment of pregnant women with the disease, and couples affected by MS who are planning a pregnancy.
The new guidelines are expected to reduce uncertainty about treatments that are considered to be safe and appropriate for this particular MS population.
The guidelines were published in the journal Practical Neurology, in an article titled “UK consensus on pregnancy in multiple sclerosis: ‘Association of British Neurologists’ guidelines.”
The proposed guidelines have been endorsed by the Association of British Neurologists, and have been reviewed by a panel of MS specialist nurses, neurologists, obstetricians, midwives, and MS patients.
“We hope that the publication of these guidelines will enable health professionals to provide more informed guidance, support and care to people with MS when they are planning a family as well as during pregnancy and the post-natal period,” Megan Roberts, health professionals program manager at MS Trust, said in a press release.
In the past few years, several new therapeutic strategies have become available to manage MS. However, there is little information about the safety of new disease-modifying therapies (DMTs) in pregnancy. This has led many women affected by MS to delay beginning treatment until after they had completed their families, which may significantly increase the chances of a poorer outcome.
“There are increasing data that delaying starting disease-modifying drugs and/or routinely stopping all disease-modifying drugs pre-pregnancy or immediately post-conception is associated with increased relapse rate during pregnancy,” researchers wrote. “This can have significant negative effects on long-term disability in women with MS.”
“The overwhelming majority of medications used in MS are [U.S. Food and Drug Administration (FDA)] category C for use in pregnancy,” meaning that the associated risk has not been ruled out based on the available information from clinical studies. “An exception is Copaxone [glatiramer acetate, marketed by Teva Pharmaceutical], which is FDA category B — either no risk in animal studies or no risk demonstrated in controlled studies in pregnant women,” researchers wrote.
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