The rates of exposure to disease-modifying therapies (DMTs) during pregnancy among women with multiple sclerosis (MS) are escalating, posing potential risks, reveals a recent study published in Multiple Sclerosis.
The landscape of MS treatment has evolved with the increasing availability of DMTs, demonstrating effectiveness in reducing disability and relapse occurrences. Despite this progress, pregnant women with MS face complex decisions regarding treatment continuation, influenced by factors such as the type of DMT, age, and disability severity.
A large-scale, nationwide study conducted in France from 2010-2021 analyzed data from 13,477 women with MS, tracking 20,567 pregnancies. The study revealed a significant rise in pregnancies exposed to DMTs, surging from 247 to 833 annually by the study’s conclusion.
Among the 7,587 pregnancies exposed to at least one DMT, beta-interferon, glatiramer acetate, and natalizumab were the most common. Notably, certain DMTs were associated with higher rates of early termination, with teriflunomide, fingolimod, anti-CD20, and dimethyl fumarate topping the list.
For pregnancies carried to term, women with MS faced higher rates of premature births and cesarean sections compared to those without the condition. Additionally, 78% of pregnancies experienced DMT discontinuation during the second trimester, while 7.6% saw a switch in DMT, and 19.5% continued the same DMT.
Maternal age beyond 35 and lower incomes were linked to reduced odds of discontinuing or switching DMTs, emphasizing socioeconomic factors in treatment decisions. The study underscores the normalization of pregnancy for women with MS but highlights the urgent need for further research, especially considering recent DMT developments lacking sufficient safety data for use during pregnancy.
