Adverse Outcomes Seen With MS Disease-Modifying Drugs in Pregnancy

THURSDAY, Jan. 2, 2025 (HealthDay News) — Disease-modifying therapy (DMT) use for multiple sclerosis (MS) in pregnancy is associated with certain adverse outcomes, including small for gestational age, according to a study published in the January issue of The Lancet Regional Health: Europe.

Nadine Bast, from Ruhr University Bochum in Germany, and colleagues conducted a prospective cohort study to examine pregnancy and neonatal outcomes in patients with MS. A total of 2,885 DMT-exposed and 837 DMT-unexposed pregnancies were compared.

The researchers found that exposure to DMTs was not associated with spontaneous abortions, preterm birth, or major congenital anomalies. Severe infections were rare but occurred more often in those exposed to fumarates (2.8 percent versus 1.0 percent in unexposed). Associations were seen for second-trimester and third-trimester natalizumab exposure and anti-CD20 exposure with systemic antibiotic use (odds ratios, 2.47, 1.75, and 2.16, respectively). Significant reductions in birth weight were seen in the sphingosine-1-phosphate group and the third-trimester natalizumab subgroup (β = −132 and −74 g, respectively). The sphingosine-1-phospate and anti-CD20 groups often had small-for-gestational-age neonates (odds ratios, 1.65 and 1.54, respectively); in the entire cohort, the rate exceeded the general German population rate (18.8 versus 10 percent).

“Our findings are critical to improve future pregnancy recommendations in women with MS seeking pregnancy by combining established and emerging evidence and increasing the number of reported pregnancies,” the authors write.

The study was funded by pharmaceutical companies; several authors disclosed ties to the pharmaceutical industry.

Abstract/Full Text