Many Women With Multiple Sclerosis Remain Untreated Around Pregnancy

Nearly half of women with multiple sclerosis (MS) remain untreated during the periods before conception, during pregnancy, and after delivery. These study results were presented at the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress 2025, held in Barcelona, Spain from September 24 to 26, 2025.

There is limited information available on the safe and effective use of disease-modifying therapies (DMTs) during family planning. Researchers conducted a retrospective, claims-based cohort study using PharMetrics Plus administrative data to evaluate real-world treatment patterns among women with MS aged 18 years and older who had live births between October 2017 and December 2023. Use of DMTs was assessed during the year preceding conception, throughout the 40 weeks of pregnancy, and during the 6-month postpartum period.

A total of 1024 women were included, among whom the mean (SD) age was 34 (5.0) years. Most participants were insured through commercial plans (57%), followed by self-insured employers (27%) and Medicaid (15%). In the period before conception, during pregnancy, and after childbirth, 42%, 60%, and 48% of the women, respectively, did not use DMTs.

Among women who received therapy before conception, the most common treatments were lower-efficacy DMTs, such as interferons or glatiramer acetate (28%), followed by ocrelizumab (26%), fumarates (15%), natalizumab (12%), and sphingosine 1-phosphate receptor modulators (10%). Postpartum, ocrelizumab use increased to 28%, followed by lower-efficacy DMTs (22%) and natalizumab (11%). During pregnancy, ocrelizumab was administered in only 2% of cases.

Between 2019 and 2023, ocrelizumab use increased from 10.2% to 28.9% in the preconception period and from 8.5% to 25.8% postpartum. Continuation after delivery was common, with 62% of women remaining on therapy at 6 months postpartum.

“This trend may reflect growing confidence in OCR [ocrelizumab] safety and efficacy, with recent evidence supporting use during pregnancy planning, while allowing for an administration-free pregnancy,” the study authors concluded.

Disclosures: This research was supported by F. Hoffmann-La Roche Ltd and Nucleus Global. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.