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Review
. 2014 Apr;20(5):527-36.
doi: 10.1177/1352458513519840. Epub 2014 Jan 20.

Pregnancy, sex and hormonal factors in multiple sclerosis

David H Miller  1 , Franz Fazekas, Xavier Montalban, Stephen C Reingold, Maria Trojano
Affiliations
Review

Pregnancy, sex and hormonal factors in multiple sclerosis

David H Miller et al. Mult Scler. 2014 Apr.

Abstract

Background: Multiple sclerosis (MS) is influenced by pregnancy, sex and hormonal factors.

Objectives: A comprehensive understanding of the role of pregnancy, sex and hormonal factors can provide insights into disease mechanisms, and new therapeutic developments and can provide improved patient care and treatment.

Methods: Based on an international conference of experts and a comprehensive PubMed search for publications on these areas in MS, we provide a review of what is known about the impact of these factors on disease demographics, etiology, pathophysiology and clinical course and outcomes.

Results and conclusions: Recommendations are provided for counseling and management of people with MS before conception, during pregnancy and after delivery. The use of disease-modifying and symptomatic therapies in pregnancy is problematic and such treatments are normally discontinued. Available knowledge about the impact of treatment on the mother, fetus and newborn is discussed. Recommendations for future research to fill knowledge gaps and clarify inconsistencies in available data are made.

Keywords: Pregnancy; hormones; sex.

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Conflict of interest statement

Conflict of interest: DHM has received honoraria through payments to his employer, UCL Institute of Neurology, for Advisory Committee and/or Consultancy advice in multiple sclerosis studies from Biogen Idec, GlaxoSmithKline, Novartis, Merck, Chugai, Mitsubishi Pharma Europe and Bayer Schering Pharma, and has also received grants through payments to his employer for performing central MRI analysis of multiple sclerosis trials from GlaxoSmithKline, Biogen Idec, Novartis and Merck. The Queen Square MS Centre at UCL Institute of Neurology is supported by the UK MS Society and UCL-UCLH Biomedical Research Centre.

FF serves on scientific advisory boards for Bayer-Schering, Biogen Idec, Genzyme, Merck Serono, Perceptive Informatics, Pfizer, Novartis and Teva Pharmaceutical Industries Ltd and has received speaker honoraria and support from Biogen Idec, Bayer Schering, Merck Serono, Novartis, Sanofi-Aventis and Teva Pharmaceutical Industries Ltd.

XM has received speaking honoraria and travel expense reimbursement for participation in scientific meetings, has been a steering committee member of clinical trials or participated in advisory boards of clinical trials in the past years with Bayer, Biogen Idec, Merck, Genentech, Genzyme, Novartis, Sanofi-Aventis, Teva Pharmaceuticals and Almirall.

SCR has served as a consultant to the National Multiple Sclerosis Society (USA) and the European Committee for Treatment and Research in MS; and has received honoraria and travel reimbursement for service on Data Safety Monitoring Boards or Advisory Boards for Bayer HealthCare, Coronado Biosciences Inc, Eli Lilly & Company, EMD Merck Serono, Genentech, F. Hoffmann-LaRoche, Ironwood Pharmaceuticals Inc, ISIS Pharmaecuticals Inc, MedImmune Inc, Novartis Pharmaceuticals Corporation, Observatoire Français de la Sclérosis en Plaques, Opexa Therapeutics, Sanofi-Aventis, SK Biopharmaceuticals, Synthon Pharmaceuticals Inc, and Teva Pharmaceutical Industries; and served as an editorial board member of the Multiple Sclerosis Journal.

MT has served on scientific Advisory Boards for Biogen Idec, Novartis, Roche and Merck Serono; has received speaker honoraria from Biogen-Idec, Bayer-Schering, Sanofi Aventis, Merck-Serono, Teva and Novartis; has received research grants from Biogen-Idec, Merck-Serono, and Novartis.

Comment in

References

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