Cyclophosphamide Use in Multiple Sclerosis: Levels Detected in Human Milk

Fierro, Maria Elena; Datta, Palika; Smillie, Christina; Bresnahan, Andrew; Baker, Teresa; Hale, Thomas W.

doi:10.1089/bfm.2018.0137

Cited by 5 publications

(5 citation statements)

References 9 publications

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“…Although it did not meet our inclusion criteria, one case report analysed breastmilk levels of CYC in a women with multiple sclerosis [ 233 ]. CYC levels in breastmilk samples were measured after IV CYC at a dose of 2.8 g, with relatively low levels identified in the milk.…”

Section: Conventional Synthetic Dmards and Immunosuppressive Therapiesmentioning

confidence: 99%

British Society for Rheumatology guideline on prescribing drugs in pregnancy and breastfeeding: immunomodulatory anti-rheumatic drugs and corticosteroids

et al. 2022

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Section: Conventional Synthetic Dmards and Immunosuppressive Therapiesmentioning

confidence: 99%

British Society for Rheumatology guideline on prescribing drugs in pregnancy and breastfeeding: immunomodulatory anti-rheumatic drugs and corticosteroids

et al. 2022

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“…It has been detected in potentially toxic concentrations in the breast milk, with a peak 4 to 5 hours after the infusion. [115][116][117][118] There are very few data on breastfed infants, but two cases of neutropenia and one case of thrombocytopenia and anaemia were reported. 119,120 Breastfeeding is contraindicated, according to the label.…”

Section: Cyclophosphamide (Cyc)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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“…CYC is excreted in breastmilk, may suppress the infants bone marrow and should be avoided during lactation. 57 , 58…”

Section: Pregnancy Planning: Generalmentioning

confidence: 99%

“…CYC is excreted in breastmilk, may suppress the infants bone marrow and should be avoided during lactation. 57,58 Tumour necrosis factor alpha inhibitors. Tumour necrosis factor alpha (TNF-α) inhibitors are contraindicated in patients with demyelinating disease as these therapies may increase inflammation and induce relapses, underlining the importance of an optimal differential diagnosis.…”

Section: Intravenous Immunoglobulinsmentioning

confidence: 99%

Susac syndrome and pregnancy: a review of published cases and considerations for patient management

Willekens

Kleffner

2021

Ther Adv Neurol Disord

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Susac syndrome (SuS) is a rare autoimmune endotheliopathy leading to hearing loss, branch retinal artery occlusions and encephalopathy. Young females are more frequently affected than males, making counselling for family planning an important issue. We reviewed published cases on SuS during pregnancy or in the postpartum period, and selected 27 reports describing the details of 33 patients with SuS. Treatment options and implications for pregnancy and breastfeeding are discussed. We propose new areas for research and suggest a management strategy.

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Cyclophosphamide Use in Multiple Sclerosis: Levels Detected in Human Milk

Cited by 5 publications

References 9 publications

British Society for Rheumatology guideline on prescribing drugs in pregnancy and breastfeeding: immunomodulatory anti-rheumatic drugs and corticosteroids

British Society for Rheumatology guideline on prescribing drugs in pregnancy and breastfeeding: immunomodulatory anti-rheumatic drugs and corticosteroids

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

Susac syndrome and pregnancy: a review of published cases and considerations for patient management

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