Casey from the MS community: Disease modifying therapies can’t be tested on pregnant women, so how do we know what the risk is during pregnancy?
Nicola Macleod, MS Specialist Nurse: Yeah, that’s right, you wouldn’t really ethically want to test drugs on pregnant women. But most of the drug companies, I think all of them, will have some post-marketing data on unplanned pregnancies. So women that have perhaps been on a disease modifying therapy and then had an unplanned pregnancy and then with consent the data has been collected to find out what the outcome of the pregnancy is. There are in some countries also sort of generic registers that are not associated with disease modifying therapies and that information can be collected from there to find out, you know, about some outcomes, how people have done.
Casey: Okay. So you talked about unplanned pregnancies. If you have an unplanned pregnancy then would you have to stop all treatment immediately?
Nicola Macleod: I think it would very much depend on which medication you’re on. And again I think, you know, you really have to consult your MS team and your general practitioner as to what you’re on, depending on, you know, I think you would have to look at the, you know, if the, sort of what the benefit of staying on, how active somebody’s MS is. By and large people would say yes, you would need to stop it, and certainly in some of the drugs you would need to stop it in preparation for conception as well and have a wash-out period. Which is why I think, you know, it really should be a – ideally – you would like it to be planned and so that all of these discussions can take place and give people the most up-to-date advice and evidence at the time before that.