Current recommendations for multiple sclerosis treatment in pregnancy and puerperium

Expert Review of Clinical Immunology

Volumn 9, Issue 7, 2013, Pages 683-692

  Ghezzi, Angelo ^a   Annovazzi, Pietro ^a   Portaccio, Emilio ^b   Cesari, Elana ^a   Amato, Maria P ^b  

^a Ospedale di Gallarate   (Italy)

^b UNIVERSITY OF FLORENCE   (Italy)

Author keywords

breastfeeding; corticosteroids; delivery; fingolimod; glatiramer acetate; IFN ; multiple sclerosis; natalizumab; postpartum; pregnancy

Indexed keywords

BETA INTERFERON; FINGOLIMOD; GLATIRAMER; NATALIZUMAB; TERIFLUNOMIDE;

CONCEPTION; CONGENITAL MALFORMATION; DELIVERY; DEVELOPMENTAL DISORDER; DRUG CONTRAINDICATION; HUMAN; LOW BIRTH WEIGHT; MULTIPLE SCLEROSIS; PRACTICE GUIDELINE; PREGNANCY; PUERPERIUM; REVIEW; SPONTANEOUS ABORTION;

CLINICAL TRIALS AS TOPIC; FEMALE; FERTILIZATION; HUMANS; INTERFERON-BETA; MALE; MULTIPLE SCLEROSIS; PEPTIDES; POSTPARTUM PERIOD; PRACTICE GUIDELINES AS TOPIC; PREGNANCY; PREGNANCY COMPLICATIONS;

EID: 84883237625     PISSN: 1744666X     EISSN: 17448409     Source Type: Journal    
DOI: 10.1586/1744666X.2013.811046     Document Type: Review

References (76)

1. Compston A, Coles A. Multiple sclerosis. Lancet 372(9648), 1502-1517 (2008).
2. Poser S, Poser W. Multiple sclerosis and gestation. Neurology 33(11), 1422-1427 (1983).
3. Korn-Lubetzki I, Kahana E, Cooper G, Abramsky O. Activity of multiple sclerosis during pregnancy and puerperium. Ann. Neurol. 16(2), 229-231 (1984).
4. Confavreux C, Hutchinson M, Hours MM, Cortinovis-Tourniaire P, Moreau T. Rate of pregnancy-related relapse in multiple sclerosis. Pregnancy in Multiple Sclerosis Group. N. Engl. J. Med. 339(5), 285-291 (1998).
5. Fernández Liguori N, Klajn D, Acion L et al. Epidemiological characteristics of pregnancy, delivery, and birth outcome in women with multiple sclerosis in Argentina (EMEMAR study). Mult. Scler. 15(5), 555-562 (2009).
6. Frith JA, McLeod JG. Pregnancy and multiple sclerosis. An Australian perspective. Clin. Exp. Neurol. 24, 1-4 (1987).
7. Nelson LM, Franklin GM, Jones MC. Risk of multiple sclerosis exacerbation during pregnancy and breast-feeding. JAMA 259(23), 3441-3443 (1988).
8. Birk K, Ford C, Smeltzer S, Ryan D, Miller R, Rudick RA. The clinical course of multiple sclerosis during pregnancy and the puerperium. Arch. Neurol. 47(7), 738-742 (1990).
9. Bernardi S, Grasso MG, Bertollini R, Orzi F, Fieschi C. The influence of pregnancy on relapses in multiple sclerosis: a cohort study. Acta Neurol. Scand. 84(5), 403-406 (1991).
10. Roullet E, Verdier-Taillefer MH, Amarenco P, Gharbi G, Alperovitch A, Marteau R. Pregnancy and multiple sclerosis: a longitudinal study of 125 remittent patients. J. Neurol. Neurosurg. Psychiatr. 56(10), 1062-1065 (1993).
11. Sadovnick AD, Eisen K, Hashimoto SA et al. Pregnancy and multiple sclerosis. A prospective study. Arch. Neurol. 51(11), 1120-1124 (1994).
12. Worthington J, Jones R, Crawford M, Forti A. Pregnancy and multiple sclerosis-A 3-year prospective study. J. Neurol. 241(4), 228-233 (1994).
13. Mueller BA, Zhang J, Critchlow CW. Birth outcomes and need for hospitalization after delivery among women with multiple sclerosis. Am. J. Obstet. Gynecol. 186(3), 446-452 (2002).
14. Salemi G, Callari G, Gammino M et al. The relapse rate of multiple sclerosis changes during pregnancy: a cohort study. Acta Neurol. Scand. 110(1), 23-26 (2004).
15. Boskovic R, Wide R, Wolpin J, Bauer DJ, Koren G. The reproductive effects of interferon therapy in pregnancy: a longitudinal cohort. Neurology 65(6), 807-811 (2005).
16. Dahl J, Myhr KM, Daltveit AK, Hoff JM, Gilhus NE. Pregnancy, delivery, and birth outcome in women with multiple sclerosis. Neurology 65(12), 1961-1963 (2005).
17. Dahl J, Myhr KM, Daltveit AK, Gilhus NE. Planned vaginal births in women with multiple sclerosis: delivery and birth outcome. Acta Neurol. Scand. Suppl. 183, 51-54 (2006).
18. Dahl J, Myhr KM, Daltveit AK, Gilhus NE. Pregnancy, delivery and birth outcome in different stages of maternal multiple sclerosis. J. Neurol. 255(5), 623-627 (2008).
19. De Las Heras V, De Andrés C, Téllez N, Tintoré M; EMPATIE Study Group. Pregnancy in multiple sclerosis patients treated with immunomodulators prior to or during part of the pregnancy: a descriptive study in the Spanish population. Mult. Scler. 13(8), 981-984 (2007).
20. Saraste M, Väisänen S, Alanen A, Airas L; Finnish Multiple Sclerosis And Pregnancy Study Group. Clinical and immunologic evaluation of women with multiple sclerosis during and after pregnancy. Gend. Med. 4(1), 45-55 (2007).
21. Hellwig K, Brune N, Haghikia A et al. Reproductive counselling, treatment and course of pregnancy in 73 German MS patients. Acta Neurol. Scand. 118(1), 24-28 (2008).
22. Chen YH, Lin HL, Lin HC. Does multiple sclerosis increase risk of adverse pregnancy outcomes A population-based study. Mult. Scler. 15(5), 606-612 (2009).
23. Fragoso YD, Finkelsztejn A, Comini-Frota ER et al. Pregnancy and multiple sclerosis: the initial results from a Brazilian database. Arq. Neuropsiquiatr. 67(3A), 657-660 (2009).
24. Kelly VM, Nelson LM, Chakravarty EF. Obstetric outcomes in women with multiple sclerosis and epilepsy. Neurology 73(22), 1831-1836 (2009).
25. Finkelsztejn A, Fragoso YD, Ferreira ML et al. The Brazilian database on pregnancy in multiple sclerosis. Clin. Neurol. Neurosurg. 113(4), 277-280 (2011).
26. Finkelsztejn A, Brooks JB, Paschoal FM Jr, Fragoso YD. What can we really tell women with multiple sclerosis regarding pregnancy A systematic review and meta-Analysis of the literature. BJOG 118(7), 790-797 (2011).
27. Vukusic S, Hutchinson M, Hours M et al.; Pregnancy In Multiple Sclerosis Group. Pregnancy and multiple sclerosis (the PRIMS study): clinical predictors of post-partum relapse. Brain 127(Pt 6), 1353-1360 (2004).
28. Bay Bjørn AM, Ehrenstein V, Holmager Hundborg H, Aagaard Nohr E, Toft Sørensen H, Nørgaard M. Use of corticosteroids in early pregnancy is not associated with risk of oral clefts and other congenital malformations in offspring. Am. J. Ther. doi:10.1097/MJT.0b013e3182491e02 (2012) (Epub ahead of print).
29. Elliott AB, Chakravarty EF. Immunosuppressive medications during pregnancy and lactation in women with autoimmune diseases. Womens. Health (Lond. Engl). 6(3), 431-440; quiz 441 (2010).
30. Ghezzi A, Zaffaroni M. Female-specific issues in multiple sclerosis. Expert Rev. Neurother. 8(6), 969-977 (2008).
31. Coyle PK. Pregnancy and multiple sclerosis. Neurol. Clin. 30(3), 877-888 (2012).
32. D'hooghe MB, Nagels G, Bissay V, De Keyser J. Modifiable factors influencing relapses and disability in multiple sclerosis. Mult. Scler. 16(7), 773-785 (2010).
33. Pastò L, Portaccio E, Ghezzi A et al.; MS Study Group of the Italian Neurological Society. Epidural analgesia and cesarean delivery in multiple sclerosis post-partum relapses: the Italian cohort study. BMC Neurol. 12, 165 (2012).
34. van der Kop ML, Pearce MS, Dahlgren L et al. Neonatal and delivery outcomes in women with multiple sclerosis. Ann. Neurol. 70(1), 41-50 (2011).
35. Borisow N, Döring A, Pfueller CF, Paul F, Dörr J, Hellwig K. Expert recommendations to personalization of medical approaches in treatment of multiple sclerosis: an overview of family planning and pregnancy. EPMA J. 3(1), 9 (2012).
36. Nelson LM, Franklin GM, Jones MC. Risk of multiple sclerosis exacerbation during pregnancy and breast-feeding. JAMA 259(23), 3441-3443 (1988).
37. Airas L, Jalkanen A, Alanen A, Pirttilä T, Marttila RJ. Breast-feeding, postpartum and prepregnancy disease activity in multiple sclerosis. Neurology 75(5), 474-476 (2010).
38. Neuteboom RF, Hintzen RQ. Breast-feeding, postpartum and prepregnancy disease activity in multiple sclerosis. Neurology 76(17), 1532; author reply 1532; author reply 1533 (2011).
39. Portaccio E, Ghezzi A, Hakiki B et al.; MS Study Group of the Italian Neurological Society. Breastfeeding is not related to postpartum relapses in multiple sclerosis. Neurology 77(2), 145-150 (2011).
40. Langer-Gould A, Huang SM, Gupta R et al. Exclusive breastfeeding and the risk of postpartum relapses in women with multiple sclerosis. Arch. Neurol. 66(8), 958-963 (2009).
41. Hellwig K, Gold R. Immune reconstitution inflammatory syndrome after withdrawal of natalizumab Neurology 76(15), 1362-1363; author reply 1363 (2011).
42. Pakpoor J, Disanto G, Lacey MV, Hellwig K, Giovannoni G, Ramagopalan SV. Breastfeeding and multiple sclerosis relapses: a meta-Analysis. J. Neurol. 259(10), 2246-2248 (2012).
43. Achiron A, Kishner I, Dolev M et al. Effect of intravenous immunoglobulin treatment on pregnancy and postpartum-related relapses in multiple sclerosis. J. Neurol. 251(9), 1133-1137 (2004).
44. Verdru P, Theys P, D'Hooghe MB, Carton H. Pregnancy and multiple sclerosis: the influence on long term disability. Clin. Neurol. Neurosurg. 96(1), 38-41 (1994).
45. Runmarker B, Andersen O. Pregnancy is associated with a lower risk of onset and a better prognosis in multiple sclerosis. Brain 118 (Pt 1), 253-261 (1995).
46. D'hooghe MB, Haentjens P, Nagels G, D'Hooghe T, De Keyser J. Menarche, oral contraceptives, pregnancy and progression of disability in relapsing onset and progressive onset multiple sclerosis. J. Neurol. 259(5), 855-861 (2012).
47. IFN-b intramuscular: US FDA drug label (2012).
48. IFN-b intramuscular: summary of product characteristics (2013).
49. IFN-b subcutaneous: US FDA drug label (2012).
50. IFN-b subcutaneous: summary of product characteristics (2013).
51. IFN-b: US FDA drug label (2012).
52. IFN-b: summary of product characteristics (2013).
53. Glatiramer acetate: US FDA drug label (2009).
54. Glatiramer acetate: summary of product characteristics (2013).
55. Fingolimod: US FDA drug label (2012).
56. Fingolimod: summary of product characteristics (2012).
57. Natalizumab: US FDA drug label (2012).
58. Natalizumab: summary of product characteristics (2013).
59. Teriflunomide: US FDA drug label (2012).
60. Sandberg-Wollheim M, Frank D, Goodwin TM et al. Pregnancy outcomes during treatment with interferon-1a in patients with multiple sclerosis. Neurology 65(6), 802-806 (2005).
61. Patti F, Cavallaro T, Lo Fermo S et al. Is in utero early-exposure to interferon a risk factor for pregnancy outcomes in multiple sclerosis J. Neurol. 255(8), 1250-1253 (2008).
62. Weber-Schoendorfer C, Schaefer C. Multiple sclerosis, immunomodulators, and pregnancy outcome: a prospective observational study. Mult. Scler. 15(9), 1037-1042 (2009).
63. Amato MP, Portaccio E, Ghezzi A et al.; MS Study Group of the Italian Neurological Society. Pregnancy and fetal outcomes after interferon-ß exposure in multiple sclerosis. Neurology 75(20), 1794-1802 (2010).
64. Fragoso YD, Finkelsztejn A, Kaimen-Maciel DR et al. Long-term use of glatiramer acetate by 11 pregnant women with multiple sclerosis: a retrospective, multicentre case series. CNS Drugs 24(11), 969-976 (2010).
65. Hellwig K, Haghikia A, Gold R. Parenthood and immunomodulation in patients with multiple sclerosis. J. Neurol. 257(4), 580-583 (2010).
66. Hellwig K, Haghikia A, Gold R. Pregnancy and natalizumab: results of an observational study in 35 accidental pregnancies during natalizumab treatment. Mult. Scler. 17(8), 958-963 (2011).
67. Salminen HJ, Leggett H, Boggild M. Glatiramer acetate exposure in pregnancy: preliminary safety and birth outcomes. J. Neurol. 257(12), 2020-2023 (2010).
68. Sandberg-Wollheim M, Alteri E, Moraga MS, Kornmann G. Pregnancy outcomes in multiple sclerosis following subcutaneous interferon-1a therapy. Mult. Scler. 17(4), 423-430 (2011).
69. Lu E, Dahlgren L, Sadovnick A, Sayao A, Synnes A, Tremlett H. Perinatal outcomes in women with multiple sclerosis exposed to disease-modifying drugs. Mult. Scler. 18(4), 460-467 (2012).
70. Giannini M, Portaccio E, Ghezzi A et al. Pregnancy and fetal outcomes after glatiramer acetate exposure in patients with multiple sclerosis: a prospective observational multicentric study. BMC Neurol. 12, 124 (2012).
71. Hellwig K, Haghikia A, Rockhoff M, Gold R. Multiple sclerosis and pregnancy: experience from a nationwide database in Germany. Ther. Adv. Neurol. Disord. 5(5), 247-253 (2012).
72. Fragoso YD, Boggild M, Macias-Islas MA et al. The effects of long-term exposure to disease-modifying drugs during pregnancy in multiple sclerosis. Clin. Neurol. Neurosurg. 115(2), 154-159 (2013).
73. Geissbühler Y, Butzkueven H, Hernández-Diaz S et al. Multinational Gilenya™ (fingolimod) pregnancy exposure registry: Preliminary results. P 02.134. Presented at: 65th Annual Meeting of the American Academy of Neurology. San Diego, CA, USA, 16-23 March 2013.
74. Hale TW, Siddiqui AA, Baker TE. Transfer of interferon ß-1a into human breastmilk. Breastfeed. Med. 7(2), 123-125 (2012).
75. Hellwig K, Gold R. Glatiramer acetate and interferon-throughout gestation and postpartum in women with multiple sclerosis. J. Neurol. 258(3), 502-503 (2011).
76. Lu E, Wang BW, Guimond C, Synnes A, Sadovnick D, Tremlett H. Disease-modifying drugs for multiple sclerosis in pregnancy: a systematic review. Neurology 79(11), 1130-1135 (2012).