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Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...
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Myasthenia Gravis: Overview and Treatment

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Related Experiment Video

Updated: May 19, 2026

Modeling Multiple Sclerosis in the Two Sexes: MOG35-55-Induced Experimental Autoimmune Encephalomyelitis
05:44

Modeling Multiple Sclerosis in the Two Sexes: MOG35-55-Induced Experimental Autoimmune Encephalomyelitis

Published on: October 13, 2023

Multiple sclerosis and pregnancy: therapeutic considerations.

Maria K Houtchens1, Channa M Kolb

  • 1Department of Neurology, Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Harvard Medical School, 1 Brookline Place #225, Brookline, MA 02445, USA. mhoutchens@partners.org

Journal of Neurology
|August 29, 2012
PubMed
Summary

Women with multiple sclerosis (MS) considering pregnancy should generally stop disease-modifying therapies beforehand. Limited data exists for some MS drugs during pregnancy and breastfeeding, requiring careful risk-benefit assessment.

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Last Updated: May 19, 2026

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Published on: September 12, 2016

Area of Science:

  • Neurology
  • Reproductive Medicine
  • Pharmacology

Background:

  • Managing multiple sclerosis (MS) in pregnant women requires balancing maternal and fetal health with treatment efficacy.
  • Existing clinical practice guidelines for MS therapy during pregnancy are limited, necessitating expert consensus and literature review.

Purpose of the Study:

  • To provide guidance on the use of disease-modifying therapies (DMTs) for women with MS before, during, and after pregnancy.
  • To inform clinical decision-making regarding the safety and efficacy of specific MS treatments in the context of conception, pregnancy, and lactation.

Main Methods:

  • Literature review of existing studies, including pregnancy registries.
  • Analysis of standard practices at an MS center.
  • Evaluation of teratogenicity and safety data for various MS medications.

Main Results:

  • Discontinuation of most DMTs is generally recommended before conception.
  • Mitoxantrone is teratogenic and requires effective contraception; fingolimod use is discouraged due to limited pregnancy outcome data.
  • Glatiramer acetate, interferon beta-1a, and natalizumab show no specific teratogenic patterns in available registry data; data for interferon beta-1b is lacking.
  • Intravenous immunoglobulin and corticosteroids may be safe during breastfeeding, but require a washout period after corticosteroid use. Limited data exists for interferon beta, glatiramer acetate, and natalizumab during lactation.

Conclusions:

  • Careful consideration of risks and benefits is crucial for MS therapies in pregnant and breastfeeding women.
  • Specific DMTs require distinct management strategies around conception, pregnancy, and lactation due to varying safety profiles and data availability.
  • Further research and data collection, particularly from pregnancy registries, are needed to establish evidence-based guidelines for MS treatment during reproduction.