b'Medicine & ResearchTheFDAalsoapprovedMavenclad have children, breastfeed, and resume their(Cladribine) to treat relapsing forms of MS, treatment without experiencing an increasedincluding relapsing remitting MS and active risk of relapses during the postpartum period.secondaryprogressiveMS.Mavencladis For the study, researchers reviewed all ofunique among FDA-approved treatments for the records from Kaiser Permanente Southernrelapsing MS in that it is an oral medication and Northern California databases andwith a maximum of 20 days of treatment identied 466 pregnancies among 375 womenoveratwo-yearperiod(nomorethanten with MS from 2008 to 2016. They revieweddays per year). Following the administration medical records and surveyed the women forof treatment over those two years, additional information about treatment, breastfeeding,courses are not to be administered. Re-treatment and relapses. with Mavenclad during years three and fourmay further increase the risk of malignancy. Women who breastfed exclusively, meaningThe safety and ecacy of reinitiating Mavenclad that the child received only breast milk for atmore than two years after completing two least two months, were about 40 percent lesstreatment courses has not been studied. likely to have a relapse than women who didDr. Thrower: The list of available treatment not breastfeed. Women who supplementedoptions for MS keeps on growing. Two new oral breast milk with formula within two monthsoptions for MS got FDA approval in the same after delivery were just as likely to have aweek. Mayzent (siponimod) and Mavenclad relapse compared with those women who did(cladribine) are approved for relapsing forms notbreastfeedatall.Ofthewomenwhoof MS and active secondary progressive MS. breastfed exclusively, 46 out of 167 resumedSo, what does active secondary progressive usingdisease-modifyingtreatments whileMS mean? The concept of dividing secondary breastfeeding.progressive MS into forms that are active or The study was presented at the Americaninactive is a newer one. Active means that Academy of Neurologys 71st annual meetingthe person is still having relapses and/or new in Philadelphia.lesions on MRI. Active secondary progressive Dr. Thrower: Pregnancy has long been knownMS is further divided into those with and to have a calming eect on MS. Traditionally,without progression of disability. I suspect we have felt that there is a higher risk of relapsethat many MS healthcare providers would for about six months after the baby is born.tend to classify a person with relapses and/or This study shows that for certain women thatnew lesions on MRI as having relapsing may not be true. The study is limited, as noted,remitting MS. Regardless, the two new oral in that few women were on natalizumab ortreatments would be approved for either.ngolimod,drugswhichmaybeusedinStudy: MS may not worsen women with more active forms of MS.after pregnancy after all The eect of breastfeeding on the risk ofAccording to a new study, multiple sclerosis postpartumrelapsesisworthnotingandmay not are up again right after pregnancy conrms the results of prior studies. Postpartumas has long been believed. Researchers said mothers can be divided into three groups;this shows that women with MS today can thosethatdontbreastfeed,thosethatmsfocusmagazine.org 58'