title: Pregnancy outcomes following maternal and paternal exposure to teriflunomide during treatment for relapsing-remitting multiple sclerosis.
abstract: BACKGROUND
  Teriflunomide, indicated for the treatment of relapsing-remitting multiple sclerosis, is contraindicated in pregnancy based on signs of developmental toxicity in the offspring of rats and rabbits; developmental toxicity has also been observed in preclinical studies of other disease-modifying therapies. Despite the requirement to use reliable contraception in clinical trials evaluating the safety and efficacy of teriflunomide, a number of pregnancies have been reported. This work reports pregnancy outcomes in teriflunomide clinical trials.
  
  
  METHODS
  Pregnancy outcomes were evaluated in a retrospective analysis of the global pharmacovigilance database. The following information was collected from the pharmacovigilance database or individual patient files: treatment allocation, pregnancy outcome, teriflunomide exposure, and use of the accelerated elimination procedure.
  
  
  RESULTS
  At data cut-off, 83 pregnancies were reported in female patients and 22 pregnancies were documented in partners of male patients. All newborns were healthy and did not have any structural or functional abnormalities at birth.
  
  
  CONCLUSIONS
  Available data do not indicate any teratogenic signals in patients treated with teriflunomide.
authors.affiliation: Department of Neurology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.
authors.forename: Bernd C
authors.initials: BC
authors.lastname: Kieseier
authors.affiliation: Global Pharmacovigilance and Epidemiology, Sanofi R&D, Chilly-Mazarin, France.
authors.forename: Myriam
authors.initials: M
authors.lastname: Benamor
keywords: Clinical trials; Multiple sclerosis; Pregnancy; Teratogenicity; Teriflunomide