Navigating multiple sclerosis treatment in women of childbearing age: balancing family planning and effective disease management

Active management of multiple sclerosis is crucial for preventing disease progression and disability. The availability of disease-modifying therapies, such as Ocrevus®(ocrelizumab), has significantly improved outcomes among people living with multiple sclerosis (MS), and changed the prognosis from a rapidly debilitating disease to a more manageable chronic condition. Given that MS is more common in women and often diagnosed during childbearing years, proactive discussions about family planning and disease management are important for optimal outcomes for both mother and baby. A combination of new studies and post-marketing data provide a greater understanding of the safety profile of Ocrevus preconception and postpartum. The Phase IV SOPRANINO study demonstrated negligible levels in breastmilk and undetectable levels in infant serum 30 days after the mother’s first postpartum Ocrevus infusion. Balancing the benefits of breastfeeding with the need for continued disease control requires individualised treatment strategies and open communication. All members of the multidisciplinary team can empower women living with MS to make informed choices and achieve optimal outcomes during their childbearing years by integrating family planning discussions into routine care and providing access to updated safety data.