Research Article| Volume 56, 103272, November 2021

UK variance in DMT advice and prescribing in MS and pregnancy: Impact of the UK consensus on pregnancy in multiple sclerosis ABN guidelines

Published:September 24, 2021DOI:


      • We performed a nationwide survey in order to assess the impact of the UK MS pregnancy guidelines and variation in practice across the UK.
      • The survey consisted of 27 questions about MS management and disease modifying treatment (DMT) prescribing prior to and during pregnancy.
      • We were able to obtain responses from a significant number of MS specialists from across the UK.
      • Whilst practice is evolving, significant variation is still seen between neurologists regarding treatment of MS in pregnancy. There is a need to continually update and communicate guidelines, particularly as recommendations change with increasing evidence.



      The ABN Multiple Sclerosis (MS) pregnancy guidelines set out to combine best current evidence with expert consensus. They were developed to provide a practical framework to support neurologists when counselling women with MS regarding pregnancy. A key objective was to reduce variation in practice and increase clarity for patients in an area of uncertainty.


      In order to assess the impact of these guidelines on practice, and assess ongoing areas of need, we conducted an online survey about MS and pregnancy. This survey was cascaded via email to UK neurologists between December 2019 and January 2020. Individuals completed this questionnaire anonymously.


      The majority of respondents reported changing their prescribing practice with interferon-beta preparations (IFN-B) and natalizumab. The ABN guidelines were the most commonly cited reason for change (76%). However, there was considerable variation in advice regarding the use of both DMTs in pregnancy.


      There is substantial variation in advice given to women with MS around pregnancy, and this is reflected in prescribing practice by UK Neurologists. Awareness of national guidelines is good, and these have driven change in a majority of MS neurologists. There remains the need to continually update and communicate these guidelines, particularly as recommendations evolve with increasing evidence.


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