According to 2019 Association of British Neurologists guidelines, if an acute relapse occurs during a patient's pregnancy, corticosteroids can be given during pregnancy and during breastfeeding. Relapse risk decreases during pregnancy but increases during the postpartum period.
Treatment with DMT should not be delayed until a woman with MS has completed her family, per the same guideline. Neuroaxonal damage begins early in RRMS, accrues over time, and is the probable cause of the progressive disability that occurs later in the disease course. Early intervention with DMTs has been shown to reduce/delay long-term disability.
In general, DMTs are not recommended during pregnancy and are used only in special circumstances. According to AAN guidelines, clinicians should counsel women to stop their DMT before conception for planned pregnancies, unless the risk for MS activity during pregnancy outweighs the risk associated with their specific DMT. Clinicians should also discuss the risks of stopping DMT with their patients.
Learn more about the treatment of MS during pregnancy.
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Cite this: Kerstin Hellwig, Christopher Luzzio. Fast Five Quiz: Treatment in Relapsed Multiple Sclerosis - Medscape - Nov 22, 2022.