Page 5 - Disease Modifying Drugs and Family Planning in MS
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PRACTICAL CONSIDERATIONS RELATING TO REVIEWING TREATMENT OF A
WOMAN WITH MS WHO IS PLANNING PREGNANCY
Is the patient's MS stable?
Yes No
Is the patient already taking a DMD? Is the patient already taking a DMD?
Yes No Yes No
Discuss continuing, switching Consider escalation (switch to higher
or stopping the DMD according efficacy DMD)
to its safety in pregnancy
Choice of DMD depends on current
Consider risk of MS disease treatment and potential for
reactivation if withdrawing compatibility with a future pregnancy
natalizumab or fingolimod
Consider avoiding fingolimod if the
patient is planning pregnancy soon
Initiate DMD to control disease
Advise the patient to go ahead activity, depending on level of disease
with the pregnancy
activity and patient preferences
Consider starting interferon ß if Ideally use a DMD that is compatible
there is concern over possible MS with a future pregnancy
disease reactivation
Discuss contraception
Re-evaluate periodically
Ensure stability of MS disease activity
for at least 1 year before advising to
proceed with a pregnancy
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