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Modifying the Course of Multiple Sclerosis in New Ways - Episode 5

Pregnancy and Smoking in Multiple Sclerosis


The MD Magazine Peer Exchange "Modifying the Course of Multiple Sclerosis in New Ways: The Latest Advances in Treatment" features a distinguished panel of physician experts discussing key topics in multiple sclerosis (MS) research and management, including the latest insights into MS pathophysiology, new medication options and their application in clinical practice, and more.

This Peer Exchange is moderated by Paul Doghramji, MD, who is a family physician at Pottstown Memorial Medical Center in Pottstown, PA, and medical director of Health Services at Ursinus College, in Collegeville, PA.

The panelists are:

  • Fred D. Lublin, MD, FAAN, FANA, the Saunders Family Professor of Neurology and director of The Corinne Goldsmith Dickinson Center for Multiple Sclerosis, and co-chief editor of Multiple Sclerosis and Related Disorders at the Icahn School of Medicine at Mount Sinai
  • Patricia K. Coyle, MD, professor of neurology, vice chair of Clinical Affairs, and director of MS Comprehensive Care Center
  • Suhayl Dhib-Jalbut, MD, professor and chief of the Department of Neurology at Rutgers, Robert Wood Johnson Medical School

“Pregnancy is not bad for MS,” said Coyle, as “you see a marked decrease in MS disease activity in the last trimester, then a temporary rebound for the three months post-partum.” This awareness is leading to new translational approaches to therapy using sex hormones, she said.

Smoking, on the other hand, is to be avoided. Lublin called it “our clearest modifiable risk factor,” as “it increases susceptibility, it increases worsening, the outcomes are worse.” Because of the extremely addictive nature of smoking, Coyle’s advice is, “don’t start and try to make sure your children don’t start smoking,” because it’s very hard to quit. The panelists agreed that quitting smoking at any stage of MS is going to be beneficial to the patient.