Cladribine and pregnancy in women with multiple sclerosis: The first cohort study

The aim of this study was to investigate the effects of cladribine use, in the last 6 months prior (56.4%) to or after (43.6%) the last menstrual period in a population of women with multiple sclerosis, on pregnancy outcomes and relapse rate during pregnancy and postpartum. Data were collected in regular interviews. Of 39 pregnancies, 27 babies have been born so far and one major congenital malformation occurred. Disease control was excellent among the cohort both during pregnancy and the postpartum period, with only one relapse recorded in each time period. Although most newborns are healthy, reinforced counselling on effective contraception 6 months after last cladribine dosing is necessary. Background: As cladribine is contraindicated in pregnancy, data to pregnancy outcomes and disease control are scarce. Objective: To investigate the effects of Cladribine use, in the last 6 months prior (56.4%) to or after (43.6%) the last menstrual period in a population of women with multiple sclerosis, on pregnancy outcomes and relapse rate during pregnancy and postpartum. Methods: Data were collected prospectively in regular telephone interviews. Results: Of 39 pregnancies, 27 babies have been born so far and one major congenital malformation occurred. Disease control was excellent among the cohort both during pregnancy and the postpartum period, with only one relapse recorded in each time period. Conclusions: Although most newborns are healthy, reinforced councelling on effective contraception 6 months after the last cladribine dosing is necessary.