What Affect Will Pregnancy Have on My Multiple Sclerosis?

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None of the drugs that we have are approved for use in MS, that is the disease modifying therapies. We tend to rank drug in a system that the FDA uses. ABCD and X so a drug that married to category of A is completely safe, proven human studies show no effect, so that's how we give folate to pregnant women, because it's perfectly safe.

Of the drugs that we have, there's only one that's a category B and that's Copaxone. The one that changes shift from TH1 to TH2, taken by an injection everyday. So the category B is probably safe but there really haven't been human studies. Most of the drugs are in category C. Aubagio, the newest one, is category X, because it interferes with DNA synthesis. It seems pretty risky in the context of pregnancy.

So patients are told, you really shouldn't be on medication, so my practice is if the person is trying to become pregnant, if they are on one of the drugs that we consider to be safe, relatively safe, like the category B and to a lesser extent category C, once you're pregnant stop them. If you're on a drug like Aubagio, which is category X, stop it well before you get pregnant and get the drug cleared out of your system, we have a way of doing that, so you can proceed without any danger.

The problem with pregnancy of course is then you're exposed. So research has shown that during the first two trimesters your chance of having activity are the same as any other point in your life. The third trimester the risk of activity drops rather dramatically. So it's like protective hence the interest in using female hormones in MS for the treatment.

And there's been a trial ongoing at UCLA now for some years on estreol in estrogen to see if it will have an effect on MS. In the three months after delivery there's an increased risk of exacerbation. So my usual guidelines to patient is, that get on to your disease modifying therapy as soon as it's reasonable after you've delivered.