Page 2 - Disease Modifying Drugs and Family Planning in MS

INTRODUCTION

The majority of people who develop MS are women. A marked increase in the
prevalence of MS in most countries has further increased the number of women
who develop MS at a time they are likely to consider planning a family. These
trends in the epidemiology of MS are evident in the Gulf region, as elsewhere.

Large families are the norm in the Middle East, and cultural issues relating to
contraception (and termination of a pregnancy exposed to a potentially unsafe
therapy) must be discussed carefully.

MS has no adverse impact per se on a woman’s fertility or a pregnancy;
conversely, pregnancy has no long-term impact on the course of MS.

Nevertheless, the onset of MS has an impact on reproductive choices.
The diagnosis of MS leads to fear and a feeling to uncertainly, and subsequently
fewer pregnancies than they expected to have, had they not developed MS.

Pregnancy also impacts the management of MS. This is because women with MS
commonly stop taking their DMD due to the fear of potential adverse effects of
treatment on their pregnancy.

Most DMDs are contraindicated in pregnancy. The management of MS is
especially challenging during pregnancy. This is because the withdrawal of
DMDs leaves the patient at a risk of increased disease activity.

This article discusses recommendations by experts from the Arab Gulf on the
application of DMD-based therapy for MS during pregnancy in the Gulf

 The recommendations are based on the impact of low or high levels of MS disease activity
on the management.

 The efficacy, safety/tolerability, and monitoring burdens of individual DMDs are key
aspects to consider when prescribing a DMD, irrespective of pregnancy status or plans.

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