Pregnancy planning and outcomes in patients with multiple sclerosis after mitoxantrone therapy: a monocentre assessment

Frau, Jessica; Coghe, Giancarlo; Casanova, P.; Sardu, Claudia; Lorefice, Lorena; Fenu, Giuseppe; Marrosu, M.G.; Cocco, Eleonora

doi:10.1111/ene.13650

Cited by 7 publications

(6 citation statements)

References 30 publications

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“…However, these case–control studies might reflect changes in sexual behaviors that might lead to conception in the prodromal period for MS. Finally, in a cohort treated with mitoxantrone (238 participants, 80 MwMS), there were no differences in number of pregnancies or rates of abortion or miscarriages between FwMS and partners of MwMS [ 59 ].…”

Section: Resultsmentioning

confidence: 99%

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Male sexual and reproductive health in multiple sclerosis: a scoping review

Toljan,

Briggs

2024

J Neurol

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Background Multiple sclerosis (MS) is a chronic neuroinflammatory disease with highest incidence during the period of optimal reproductive health. This scoping review aimed to identify and summarize available data on sexual/reproductive health in males with MS (MwMS). Methods This review was based on PRISMA extension for Scoping Review. PubMed database was searched for keyword “multiple sclerosis” alongside keywords “sexual health”, “reproductive health”, “family planning”, “male fertility”, “male infertility”, “sexual dysfunction”, and “erectile dysfunction”, iteratively using the “AND” logical operator. Descriptive analysis was performed on the included articles. Results Thirty-four studies were included, and four topics emerged: sexual dysfunction, erectile dysfunction, fertility, and family planning. Sexual dysfunction is common in MwMS (35–72%), yet only a minority of MwMS discuss their sexual health with their treatment teams. Both MS disability and depression were associated with sexual dysfunction in MwMS, with erectile dysfunction and decreased libido as the most prevalent aspects of sexual dysfunction. Positively, phosphodiesterase-5 inhibitors appear effective for treating erectile dysfunction and improving sexual quality of life in MwMS. There may also be a relationship between MS and male infertility, though changes in sexual behavior may underlie this association. Finally, a prominent knowledge gap was observed for disease-modifying therapy use and family planning in MwMS. Conclusion Sexual dysfunction is common, impacted by MS severity, and associates with decreased quality of life in MwMS. Communication barriers regarding sexual and reproductive health appear to exist between MwMS and providers, as do literature gaps related to MS therapeutics and sexual/reproductive health.

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Section: Resultsmentioning

confidence: 99%

“…Finally, in a cohort treated with mitoxantrone (238 participants, 80 MwMS), there were no differences in number of pregnancies or rates of abortion or miscarriages between FwMS and partners of MwMS [ 59 ].…”

Section: Resultsmentioning

confidence: 99%

Male sexual and reproductive health in multiple sclerosis: a scoping review

Toljan,

Briggs

2024

J Neurol

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“…These findings are supported by other studies, even when the mother and foetus might have been exposed to DMT, for example, interferon-beta-1b, 24 natalizumab, 25 teriflunomide 26 or even mitoxantrone. 9 Notably, if the woman had been exposed to fingolimod, 27 she had a slightly higher risk of spontaneous abortions than the general population. Thus, MS by itself should not predispose women to a higher rate of spontaneous abortions and ectopic pregnancies.…”

Section: Discussionmentioning

confidence: 99%

“…The rate of spontaneous abortions and ectopic pregnancies among women with MS seems to be comparable to that of the general population. [8][9][10] There has only been one previous pregnancy study in a nationwide population that originated from Norway and reported 649 live births by 461 women with MS compared to 2.1 million births among 1.0 million women without MS during 1967-2002. 11 The objectives of this study are to investigate the number of pregnancies and live births among women and men in the Danish MS population.…”

Section: Manuscript Introductionmentioning

confidence: 99%

Reproductive history of the Danish multiple sclerosis population: A register-based study

et al. 2019

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Background: A diagnosis of multiple sclerosis (MS) may impact the choice of parenthood. Objective: To investigate the number of live births, abortions and ectopic pregnancies among persons with MS. Methods: From the Danish Multiple Sclerosis Registry, we extracted data from all persons diagnosed with MS from 1960 to 1996 and matched each MS person with four reference persons. We used a negative binomial regression model for the live births and Poisson regression model for abortions and ectopic pregnancies. The total fertility rate (TFR) during 1960–2016 and the annual number of live births in the MS population were analysed. Results: Persons with MS had fewer children than reference persons. Fewer women with MS had elective abortions after diagnosis (incidence rate ratio (IRR) = 0.88; 95% confidence interval (CI) = 0.78–1.00) than reference persons. There was no difference regarding the number of elective abortions, spontaneous abortions or ectopic pregnancies after onset. The TFR was lower for women with MS than for reference persons, and the number of annual live births by MS persons increased during 1960–2016. Conclusion: MS seems to considerably impact reproductive choices, especially after clinical diagnosis, resulting in the MS population having fewer children than the general population.

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“…There are only a few case reports of exposure during pregnancy in MS women. [208][209][210] Azathioprine (AZA) AZA is not teratogenic in animals. Studies on women with chronic inflammatory bowel disease and inflammatory rheumatisms provide most of the data.…”

Section: Alemtuzumab (Alz)mentioning

confidence: 99%

Pregnancy and multiple sclerosis: 2022 recommendations from the French multiple sclerosis society

Vukusic

Ciron²,

Maillart

et al. 2022

Mult Scler

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Objective: The objective of this study was to develop evidence-based recommendations on pregnancy management for persons with multiple sclerosis (MS). Background: MS typically affects young women in their childbearing years. Increasing evidence is available to inform questions raised by MS patients and health professionals about pregnancy issues. Methods: The French Group for Recommendations in Multiple Sclerosis (France4MS) reviewed PubMed and university databases (January 1975 through June 2021). The RAND/UCLA appropriateness method was developed to synthesise the scientific literature and expert opinions on healthcare topics; it was used to reach a formal agreement. Fifty-six MS experts worked on the full-text review and initial wording of recommendations. A group of 62 multidisciplinary healthcare specialists validated the final proposal of summarised evidence. Results: A strong agreement was reached for all 104 proposed recommendations. They cover diverse topics, such as pregnancy planning, follow-up during pregnancy and postpartum, delivery routes, locoregional analgesia or anaesthesia, prevention of postpartum relapses, breastfeeding, vaccinations, reproductive assistance, management of relapses and disease-modifying treatments. Conclusion: The 2022 recommendations of the French MS society should be helpful to harmonise counselling and treatment practice for pregnancy in persons with MS, allowing for better and individualised choices.

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Pregnancy planning and outcomes in patients with multiple sclerosis after mitoxantrone therapy: a monocentre assessment

Cited by 7 publications

References 30 publications

Male sexual and reproductive health in multiple sclerosis: a scoping review

Male sexual and reproductive health in multiple sclerosis: a scoping review

Reproductive history of the Danish multiple sclerosis population: A register-based study

Pregnancy and multiple sclerosis: 2022 recommendations from the French multiple sclerosis society

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