Study data regarding the use of interferon beta during and after pregnancy have been limited. Therefore, registry data were collected and analyzed from nearly 1000 women from 26 European countries between 2009 and 2017 [7]. The prevalence of pregnancy outcomes was associated with those in the general population. It was shown that the use of interferon-beta-1a and -1b did not increase the incidence of congenital malformations. Overall, 82.0% of pregnancies resulted in a live birth without congenital anomaly. The prevalence of spontaneous abortions was also comparable to those in the general population. The experts concluded that the data collected do not suggest that IFN-beta exposure before conception and\/or during pregnancy adversely increases the rate of congenital anomalies or spontaneous abortions. Accordingly, Plegridy\u00ae and Avonex\u00ae can be used in pregnancy if clinically necessary [8,9].<\/p>\n
Breastfeeding also possible with MS therapy<\/strong><\/p>\n In addition, information on the passage of interferon-beta into breast milk and its chemical and physiological properties suggest that the amounts excreted into breast milk are negligible. No adverse effects have been reported in breastfed infants of women treated with interferon beta [8,9,15,16]. Therefore, Plegridy\u00ae and Avonex\u00ae can also be used during breastfeeding [8,9].<\/p>\n Benefit-risk assessment in view<\/strong><\/p>\n Oral therapies are usually contraindicated for use before, during, and after pregnancy. The preparations should be discontinued months before a planned pregnancy in order to achieve a sufficiently low plasma concentration. Otherwise, an increased prevalence with regard to congenital malformations is to be expected. The terminal half-life of monomethyl fumarate (Tecfidera\u00ae) is comparatively short at one hour [10]. After 24 hours, no circulating drug is detectable in the majority of patients. Therefore, if pregnancy begins during treatment, a benefit-risk assessment should be performed. Tecfidera\u00ae should be used during pregnancy only if the patient’s clinical findings mandate treatment and the potential benefit justifies the potential risk to the fetus [10,11]. Termination of therapy should be considered. However, initiation of treatment during an existing pregnancy is contraindicated. Whether breastfeeding or treatment should be interrupted after pregnancy must be decided on an individual basis.<\/p>\n Family planning without time pressure<\/strong><\/p>\n On average, it takes 7.5 months for an MS patient to become pregnant [12]. Because concomitant contraception is indicated in many treatment regimens for highly active MS, there can be great time pressure when family planning is pending. Natalizumab (Tysabri\u00ae) therapy, on the other hand, does not require concomitant contraception, which in principle allows family planning without pressure [13]. Also, the preparation does not seem to affect fertility. In an observational study, the results showed no specific pattern of malformations that would indicate a drug effect. The spontaneous abortion rate was also consistent with that of the general population [14]. Natalizumab should not be used during pregnancy unless the patient’s clinical findings necessitate treatment with Tysabri. Because the effect on neonates and infants is not known, breastfeeding should be discontinued during Tysabri\u00ae treatment [13].<\/p>\n Safety for mother and child through close cooperation<\/strong><\/p>\n In summary, MS and family planning should be quite possible nowadays. A close interdisciplinary exchange between the treating neurologist and the gynecologist is important for the well-being of the patient during and after pregnancy. <\/p>\n Technical information PLEGRIDY\u00ae<\/a><\/span><\/p>\n Technical information AVONEX\u00ae<\/a><\/span><\/p>\n Technical information TECFIDERA\u00ae<\/a><\/span><\/p>\n Technical information TYSABRI\u00ae<\/a><\/span><\/p>\n Literature<\/strong><\/p>\n![\"\"](\"https:\/\/assets.medizinonline.com\/sites\/default\/files\/field\/images\/biogen-2_tabelle_kopie.png\")
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