| Multiple sclerosis and pregnancy: therapeutic considerations. | |
| | |
MedLine Citation:
|
PMID: 22926165 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
For women with multiple sclerosis (MS) who become pregnant, the risks and benefits of ongoing therapy for the health of both the mother and the fetus must be carefully considered. Based on a literature review and our MS center's standard practices, we provide guidance to aid clinical decision making in the absence of clear evidence-based clinical practice guidelines. Women seeking to achieve pregnancy should generally discontinue disease-modifying therapy use prior to attempting conception. For example, the immunosuppressant mitoxantrone is teratogenic and should be prescribed only with the assurance of effective contraception. Conception should be discouraged for patients on fingolimod, because of the limited information available on human pregnancy outcomes. Current evidence, including data from pregnancy registries for glatiramer acetate (GA), interferon beta-1a (IFNβ-1a), and natalizumab, has not shown specific patterns of malformations suggesting teratogenicity. Pregnancy registry data have not been published for IFNβ-1b. During breastfeeding, intravenous immunoglobulin and corticosteroids are generally safe and may be associated with a reduction in postpartum relapses; however, a washout period is recommended between corticosteroid administration and the resumption of breastfeeding. Clinical data on the use of IFNβ, GA, and natalizumab during lactation are limited. Mitoxantrone is contraindicated during breastfeeding, and fingolimod should be avoided in nursing mothers, because of a lack of data. |
| | |
Authors:
|
Maria K Houtchens; Channa M Kolb |
Related Documents
:
|
21945745 - Treatment of cornual heterotopic pregnancy via selective reduction without feticide drug. 18658115 - Health behavior in mexican pregnant women with a history of violence. 16672855 - Impact of physical activity during pregnancy and postpartum on chronic disease risk. 11077945 - Perception and practice of rest during pregnancy among mothers and family decision-makers. 3893025 - Analgesia and maternal side effects of pudendal block at delivery. a comparison of thre... 20633305 - Assessing cephalopelvic disproportion: back to the basics. |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2012-8-25 |
Journal Detail:
|
Title: Journal of neurology Volume: - ISSN: 1432-1459 ISO Abbreviation: J. Neurol. Publication Date: 2012 Aug |
Date Detail:
|
Created Date: 2012-8-28 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0423161 Medline TA: J Neurol Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
Department 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. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Enzyme replacement therapy in late-onset Pompe disease: a systematic literature review.
Next Document: Advancing neurotrophic factors as treatments for age-related neurodegenerative diseases: developing ...