Role of Family Planning in Women With Multiple Sclerosis in Switzerland: Results of the Women With Multiple Sclerosis Patient Survey

Kamm, Christian P.; Muehl, Sarah; Mircsof, Dennis; Müller, Stefanie; Czapliński, Adam; Achtnichts, Lutz; Stellmes, Petra; Virgilio, Gabrielle Di

doi:10.3389/fneur.2018.00821

Cited by 10 publications

(14 citation statements)

References 21 publications

(20 reference statements)

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“…Nowadays, family planning influences the selection of DMT as determined in a recent 2018 questionnaire-based study of wMS in Switzerland ( 17 ). In this regard, the availability of DMTs with no safety concerns when administered during pregnancy is a valid opportunity to minimize the risk of reactivation of the disease in those wMS attempting to get pregnant.…”

Section: Discussionmentioning

confidence: 99%

“…Studies assessing how MS affects family planning decision making for pwMS are scattered. It has been suggested that several MS-related factors may influence family planning decision making, including the impact of MS on the patient's quality of life ( 16 ), or treatment options before and during pregnancy ( 17 ). However, the influence of such factors on family planning are rapidly changing with the increase in possible treatments, where patients are much less disabled than they were previously.…”

Section: Introductionmentioning

confidence: 99%

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Family Planning Decision Making in People With Multiple Sclerosis

Bonavita

Lavorgna

Worton³

et al. 2021

Front. Neurol.

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Introduction: The majority of people diagnosed with MS are of childbearing or child fathering age, therefore family planning is an important issue for both women and men with MS. Fertility and the course of pregnancy are not affected by MS; however, people with MS (pwMS) may have concerns that there will be a greater risk of complications to the mother and/or adverse pregnancy outcomes either due to the disease or to ongoing medication. This survey aimed to understand family planning decision making in pwMS and related unmet educational needs.Methods: A total of 332 pwMS across the USA, UK, France, Germany, Italy, and Spain were recruited from a specialist patient panel agency to participate in a smartphone-enabled standing panel. The 80-question survey focussed on decision making and information sources for pwMS regarding family planning, as well as behavior during and after pregnancy. Male patients with MS did not respond to specific questions on pregnancy. Survey results were directly compared with the 2016 US and 2010 UN census data.Results: pwMS were more likely to have no children than the general population, particularly in the subgroup of patients aged 36–45 years. A total of 56% of pwMS reported that the disease affected, with different degrees of impact, their family planning decision making. Of these, 21% significantly changed their plans for timing of pregnancy and the number of children, and 14% decided against having children. Participants indicated that healthcare professionals were the primary source of information on family planning (81% of responses). The timing of planned pregnancy was not considered when selecting treatment by 78% of participants.Conclusion: MS was found to significantly impact family planning decision making, with pwMS significantly less likely to have children in comparison with the general population.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Family Planning Decision Making in People With Multiple Sclerosis

Bonavita

Lavorgna

Worton³

et al. 2021

Front. Neurol.

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“…Furthermore the women in the analysis were concerned about the effect of medication on the menstrual cycle, and the possible complication of infertility treatment due to MS [22]. A survey regarding pregnancy-related concerns in women with MS from Switzerland found that; worsening of the disease course after pregnancy; the health of the unborn child; and worries about being able to take care of the child occurred in respectively 60%, 47% and 45% of the 271 women included [23].…”

Section: Fertilitymentioning

confidence: 99%

Pharmacotherapeutic considerations in women with multiple sclerosis

Andersen

Magyari

2020

Expert Opinion on Pharmacotherapy

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Introduction: Multiple sclerosis (MS) is a chronically progressive disease of the central nervous system. The relapsing form of the disease predominantly affects women with onset between the ages 20 to 40 years. Therefore, timing, choice, and treatment options should take pregnancy planning into consideration to accommodate both the needs and safety of the mother and health of the fetus. Areas covered: In this review, the authors discuss and summarize the recent evidence of different pharmacotherapeutic possibilities in the treatment of women with MS. Expert opinion: There is evidence that disease modifying therapy reduces the risk of relapses and diminishes disability progression in people with relapsing MS. The disease is often diagnosed in the childbearing years, and thus pregnancy planning can possibly be a part of the pharmacotherapeutic considerations. The management of women planning pregnancy requires a balancing of risks. The clinician must consider the risks related to treatment discontinuation versus the risk of exposing the developing fetus to drugs that are potential fetotoxic. Randomized controlled trials of medication safety-if used during pregnancy, are prohibited for ethical reasons; hence, the evidence is continuously gathered from observational data, post-authorization studies and pregnancy registries.

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“…The goals of management of all people with RRMS relate to the disease (reducing relapse rates, preserving long-term functional status), the treatment (avoiding side-effects as far as possible, minimizing the burden of treatment and its associated monitoring) and the patient's lifestyle (maintaining quality of life, supporting good adherence to therapy, delivering treatment in a way that fits well with the individual patient's lifestyle and accommodating the patient's need to plan a family) [66][67][68] . Disease activity may alter priorities to some extent.…”

Section: Goals Of Treatmentmentioning

confidence: 99%

Management of relapsing–remitting multiple sclerosis in Qatar: an expert consensus

Deleu

Canibaño

Mesraoua

et al. 2019

Current Medical Research and Opinion

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Healthcare systems vary greatly between countries. International, evidence-based guidelines for the management of multiple sclerosis (MS) may need to be adapted for use in particular countries. Two years ago, the authors published a comprehensive consensus guideline for the management of MS in Qatar. Since that time, the availability of disease-modifying treatments for relapsing-remitting MS (RRMS), and our understanding of how to apply those treatments, has increased. The authors present an update to our guidance, focussing on the management of relapsing-remitting RRMS. In particular, the authors consider the optimal use of different DMTs in patients presenting with mild, medium or high disease activity.

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Role of Family Planning in Women With Multiple Sclerosis in Switzerland: Results of the Women With Multiple Sclerosis Patient Survey

Cited by 10 publications

References 21 publications

Family Planning Decision Making in People With Multiple Sclerosis

Family Planning Decision Making in People With Multiple Sclerosis

Pharmacotherapeutic considerations in women with multiple sclerosis

Management of relapsing–remitting multiple sclerosis in Qatar: an expert consensus

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