Use of Disease Modifying Therapies for Multiple Sclerosis Has No Ill Effect on Pregnancy Outcomes

The following article is part of conference coverage from the 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in Berlin, Germany. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from ECTRIMS 2018.

Disease modifying  therapies do not affect the fertility or pregnancy outcomes for female patients with relapsing-remitting multiple sclerosis (MS), according to research presented at the 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis, held October 10-12, 2018, in Berlin, Germany.

Researchers evaluated whether the decision to receive immunomodulatory treatment for MS should be influenced by the patient’s intention to become pregnant in the near future. Data obtained from patients with relapsing-remitting MS who had given birth between 2002 and 2017 were analyzed to determine the effect of disease modifying therapies on disease progression, fertility, and pregnancy outcomes. A multivariate analysis was performed and adjusted to disease severity, age, previous pregnancies, and known fertility problems.

Patients (N=125; 31.8 years old ±4.6 at birth, range 20-45) were divided into 3 medication use groups: patients not treated in the 3 months before pregnancy, patients treated in the 3 months before pregnancy, and patients treated during pregnancy. Study outcomes included the need for fertility treatment, pregnancy complications, attacks during pregnancy, birth type, child percentile, birth weight, delivery week, attacks to 1 year postpartum, and change in Expanded Disability Status Scale (EDSS) scores 1 year postpartum.

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A total of 219 live births from 125 patients with MS were evaluated. Thirteen of these patients were treated with disease modifying therapies during pregnancy. Twelve of the patients (divided equally between medication use groups) needed fertility treatment to conceive. No significant between-group differences were found regarding the need for fertility treatments and time to pregnancy, pregnancy outcomes and complications, changes in EDSS score, and attacks during and after pregnancy.

Study investigators concluded that the findings indicate that the “decision regarding [disease modifying therapies] treatment in [relapsing-remitting] MS patients during childbearing years should not be influenced by the question of pregnancy in the near future.”

Disclosures: Several researchers received consulting fees or conducted contracted research for Bayer, Biogen Idec, EMD Serono, Genzyme, and/or Roche.

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Keshet P, Eldad K, Stern Y, et al. Does use of disease modified therapies for multiple sclerosis affect fertility and pregnancy outcomes? Presented at: 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis 2018. October 10-12, 2018; Berlin, Germany. Poster 936.