Page 8 - Disease Modifying Drugs and Family Planning in MS

CONSENSUS RECOMMENDATIONS ON AVOIDING REBOUND MS DISEASE
BREASTFEEDING
ACTIVITY IN PATIENTS RECEIVING FINGOLIMOD OR NATALIZUMAB WHO ARE
OR INTEND TO BECOME PREGNANT

Patient currently receiving Patient currently receiving
fingolimod natalizumab

Any patient receiving natalizumab is
High MS disease activity Stable MS disease activity likely to have high MS disease activity

Long-term planning Stop fingolimod, and Active approach:
option: switch to interferon ß Continue with natalizumab to
Stop fingolimod, switch to (high consensus) 30 weeks' gestation with infusion
cladribine tablets or intervals extended to 6 weeks
alemtuzumab Stop fingolimod, (high consensus)
(high consensus) monitor regularly
(weak consensus) Alternative approach:
Short-term planning Withdraw natalizumab on a
option: positive pregnancy test, especially
Stop fingolimod, and if the patient's MS is well
switch to natalizumab controlled (low consensus)
(high consensus)

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