Methylprednisolone Concentrations in Breast Milk and Serum of Patients with Multiple Sclerosis Treated with IV Pulse Methylprednisolone

Karahan, Serap Zengin; Boz, Cavit; Terzı, Murat; Aktoz, Gonulden; Şen, Sedat; Ozbudun, Bilge; Çağlar, A.; Şener, Murat

doi:10.1016/j.clineuro.2020.106118

Cited by 14 publications

(8 citation statements)

References 15 publications

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“…Studies of corticosteroid use in pregnancy were confounded by multiple concomitant medications and use in high-risk pregnancies; particularly the fluorinated steroids, which are used to prevent or treat preterm labour and complications such as foetal lung immaturity. Therefore, we searched for further evidence on corticosteroids used to treat rheumatic disease and identified additional studies: 11 on prednisolone with ( n = 1218) pregnancies [ 31 , 71–80 ] and one on methylprednisolone with ( n = 12) pregnancies [ 81 ]. This evidence was combined with the previous studies: 47 on prednisolone ( n = 1503) [ 43 , 46 , 48 , 51–53 , 55 , 57 , 59–61 , 82–117 ]; 31 on dexamethasone ( n = 11 214) [ 48 , 54 , 88 , 97 , 118–144 ]; 27 on betamethasone ( n = 27 746) [ 118–120 , 125 , 126 , 128 , 130 , 131 , 140 , 143 , 145–162 ]; and 10 on general corticosteroid use ( n = 785) [ 42 , 49 , 50 , 54 , 163–168 ].…”

Section: The Guidelinementioning

confidence: 99%

“…One study, comprising 19 pregnancy and breastmilk exposures, found that prednisone and prednisolone exhibit dose- and concentration-dependent pharmacokinetics during pregnancy, and infant exposure to these agents via breastmilk is minimal [ 76 ]. Another study of 12 patients with multiple sclerosis found the transfer of methylprednisolone into breastmilk to be low even when maternal serum concentration levels were highest at the end of an infusion, and although these levels were not considered to pose a threat to the infant, they state that mothers may choose to wait two to four h to further limit an infant’s exposure [ 81 ].…”

Section: The Guidelinementioning

confidence: 99%

See 1 more Smart Citation

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: The Guidelinementioning

confidence: 99%

Section: The Guidelinementioning

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: Resultsmentioning

confidence: 99%

“…In infants breastfed 4 hours after the infusion, plasma concentrations do not exceed the endogenous production of cortisol, and no adverse event was reported after 3 to 12 months of follow-up. [134][135][136][137] Intravenous immunoglobulins (IVIgs) IVIgs do not increase foetal or obstetrical risks when used during pregnancy in women with MS or other inflammatory diseases. However, their efficacy has not been demonstrated in treating or preventing MS relapses.…”

Section: Corticosteroids (Cs)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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“…Vi har tidligere advart mot steroidbehandling hos ammende kvinner (1). Nyere studier har imidlertid vist at overgangen til morsmelk er lav, og barnet eksponeres bare for 0,50 % av dosen mor mo ar (11). Vi mener derfor at det nå foreligger dokumentasjon som tilsier at det trygt å behandle a akker med steroider også i ammeperioden.…”

Section: A L E Mt Uzum a Bunclassified

Breastfeeding and treatment for multiple sclerosis

Torkildsen¹,

Rød²,

Liu³

et al. 2022

Tidsskriftet

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Øivind Torkildsen er professor og seksjonsleder for Nevroseksjonen, Universitetet i Bergen, overlege ved Nevrologisk avdeling, Haukeland universitetssjukehus og medlem av referansegruppen til Nasjonal kompetansetjeneste for multippel sklerose. Forfa eren har fylt ut ICMJE-skjemaet og oppgir følgende interessekonflikter: Han har mo a foredragshonorar og forskningsstø e fra Biogen, Roche, Novartis, Merck og Sanofi. Brit Ellen Rød er lege i spesialisering i nevrologi ved Nevrologisk avdeling, Haukeland universitetssjukehus og stipendiat ved Universitetet i Bergen. Forfa eren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. Lars Bø er overlege ved Nevrologisk avdeling, Haukeland universitetssjukehus, professor ved Universitetet i Bergen og leder for Nasjonal kompetansetjeneste for multippel sklerose. Forfa eren har fylt ut ICMJE-skjemaet og oppgir følgende interessekonflikter: Han har mo a foredragshonorar fra Merck og honorar for arbeid som sakkyndig fra Synthon. Stig Wergeland er medisinsk leder av Nasjonalt MS-register, overlege ved Nevrologisk avdeling, Haukeland universitetssjukehus og førsteamanuensis ved Universitetet i Bergen. Forfa eren har fylt ut ICMJE-skjemaet og oppgir følgende interessekonflikter: Han har mo a honorar fra Biogen, Novartis og Sanofi.

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Methylprednisolone Concentrations in Breast Milk and Serum of Patients with Multiple Sclerosis Treated with IV Pulse Methylprednisolone

Cited by 14 publications

References 15 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

Breastfeeding and treatment for multiple sclerosis

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