Table 3. DMT during pregnancy.
DMT: disease-modifying treatment, IFN-b: Interferon beta, MS: multiple sclerosis, DMF: Dimethyl fumarate
| Statements | Answer (n, % agreement) | Reached consensus at round | |
| Statement 23 | For patients on IFN-b, it may be considered safe to continue treatment during pregnancy and lactation if it is clinically necessary. | Agree (42,97,6%) | 1º |
| Statement 24 | DMF and glatiramer acetate should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus. | Not reached | |
| Statement 25 | Would you maintain glatiramer acetate throughout the pregnancy in a treated patient with a controlled disease? | No (29, 72,5%) | 3º |
| Statement 26 | In highly active patients, alemtuzumab and cladribine could facilitate family planning, pregnancy, and breastfeeding, due to their pharmacologic characteristics. | Agree (42,97,6%) | 1º |
| Statement 27 | In patients on alemtuzumab, the risks of potentially serious adverse effects on the fetus due to drug-associated secondary autoimmunity problems should be considered. | Agree (32, 74,4%) | 1º |
| Statement 28 | In highly active MS patients, the possibility of withholding DMT treatment throughout the pregnancy should be considered. | Agree (35, 81,4%) | 1º |
| Statement 29 | In case of relapses during pregnancy and its possible treatments: | ||
| a.- It is recommended to use intravenous methylprednisolone and prednisolone, whereas dexamethasone is contraindicated. | Agree (33, 76,7%) | 1º | |
| b.- The use of plasmapheresis or immunoglobulins may be considered if clinically necessary. | Agree (40, 93%) | 1º | |
| c.- A case of a mild relapse, could not be treated. | Agree (37, 86%) | 1º | |
| d.- If there is a relapse, corticosteroids should be used after the second trimester. | Not reached | ||
| e.- In case of disabling relapses, would you recommend treating it with immunoglobulins? | Not reached | ||
| f.- In case of disabling relapses, would you recommend treating it with plasmapheresis? | Yes 34 (80,1%) | 2º | |
| Statement 30 | Patients with MS can receive epidural anesthesia and can deliver just like any woman unaffected by MS. | Agree 43, 100% | 1º |
| Statement 31 | In a patient with very active MS, would you maintain natalizumab during pregnancy? | Yes (39, 97,5%) | º |