2026 Rachel Horne Prize Winner Sandra Vukusic, MD, PhD, on Advancing Women's Health in MS

Multiple sclerosis (MS) affects an estimated 3.1 million patients worldwide and is up to 3 times more common in women than in men. Since it is generally diagnosed between the ages of 20 and 40, many women receive their diagnosis during their reproductive years.¹ For decades, women with MS were often advised against pregnancy because of concerns that it would worsen the disease.

The prospective Pregnancy in Multiple Sclerosis (PRIMS) study helped change that view. Originally published in 2004, It showed that relapse rates decline during pregnancy, particularly in the third trimester, and rise in the first 3 months postpartum before returning to prepregnancy levels, and that most women did not relapse during the postpartum period.^2,3

Sandra Vukusic, MD, PhD, professor of neurology at the University of Lyon, Hospices Civils de Lyon, and scientific coordinator of OFSEP, has studied women's health in MS for more than 2 decades. She led the development of the 2022 French MS society recommendations on pregnancy, which address pregnancy planning, postpartum relapse prevention, breastfeeding, reproductive assistance, and DMT management.⁴

Vukusic was recently named the 2026 winner of the Rachel Horne Prize for Women's Research in MS, an international award that recognizes female scientists making significant contributions to research on women-specific health issues in multiple sclerosis. For this, she will receive a $40,000 prize at the upcoming joint ACTRIMS-ECTRIMS Congress in Toronto, Canada, on October 23, 2026.¹ In a new Q&A, Vukusic spoke with NeurologyLive^® to discuss what the award signals for women-focused research, the core message neurologists should bring to pregnancy counseling, practical steps to avoid therapeutic inertia, and the areas of women's health in MS she believes still need more attention.

NeurologyLive: What does receiving the 2026 Rachel Horne Prize mean to you, and what do you hope it signals to clinicians about the importance of women-focused research in MS?

Sandra Vukusic, MD, PhD: I am so truly delighted, honored and impressed to receive this international scientific award and to follow in the footsteps of such extraordinary researchers and clinicians. I am so grateful to Rachel Horne and her family for shining the spotlight on both women in science and women’s health. Women matter!

The message for clinicians is that women living with MS should not be penalized twice: once because they have MS, and once because they are women. And we still have so many situations related to women’s health that are under-considered by neurologists. There has been a lot of improvements regarding management of family planning, pregnancy and breastfeeding in the past two or three decades, and today, I hope neurologists would all ask their patients about their family plans. But how many would ask about the menopausal status? Or gynecological cancer screening? Or peripartum mood disorders? Still a lot to be done here, by dedicated research projects and by a rapid transfer to clinical practice.

What is the single most important message you would give neurologists today when counseling a woman with MS who is considering pregnancy?

Quite simple indeed: everything is possible! First, pregnancy is normal in women with MS, meaning pregnancy and fetal outcomes are similar as in the general population. Second, there are treatment options, including high efficacy treatments, that are compatible with pregnancy and with breastfeeding and that can perfectly control disease activity in pregnancy and the post-partum, without risks to the fetus.We (and our patients) don’t have to choose anymore between pregnancy and MS.

Your team found that women of childbearing age are less likely than men to receive high-efficacy therapies; what can clinicians do to address this treatment disparity in practice?

I think the most important message is the one discussed previously – we now have treatments options that are compatible with pregnancy and breastfeeding. We should treat women as if they were men, with the same goals. We should use high efficacy DMTs if we need high efficacy DMTs! We just need to choose those that are safe in pregnancy and breastfeeding. And we should not wait anymore to be introducing or switching DMTs because of family planning.

How should clinicians approach managing disease-modifying therapy before, during, and after pregnancy, and where do you see the biggest remaining gaps in evidence?

I don’t think there are really remaining gaps in evidence in that field. The main gap is probably the dissemination of scientific evidence, beyond official product information to a large audience, neurologists but also patients living with MS. This is the reason why ECTRIMS 2026 guidelines will focus on family planning, fertility treatment, pregnancy and breastfeeding in MS, but also in related rare diseases, NMOSD and MOGAD. They will be presented during the joint ECTRIMS-ACTRIMS meeting in Toronto this year.

Looking ahead, what research questions in women's health and MS are you most excited about, whether in assisted reproduction, sex-based differences, or registry data from OFSEP?

I am convinced registries can be used to answer many questions. I am very curious to see in the future if recommendations have been able to change people’s behavior in MS management in pregnancy. I also hope that we will be able to gather scientific evidence much more quickly than we did with pregnancy, and that it will take less than 20 or 30 years to change practices regarding other aspects of women’s health, such as menopause, mental health, and cancer prevention and screening.

Transcript edited for clarity. Click here for more of our MS coverage.

REFERENCES
1. Professor Sandra Vukusic wins the 2026 Rachel Horne Prize for Women's Research in MS. News release. Rachel Horne Prize. September 30, 2026. Accessed October 1, 2026.
2. Confavreux C, Hutchinson M, Hours MM, Cortinovis-Tourniaire P, Moreau T. Rate of pregnancy-related relapse in multiple sclerosis. Pregnancy in Multiple Sclerosis Group. N Engl J Med. 1998;339(5):285-291. doi:10.1056/NEJM199807303390501
3. Vukusic S, Hutchinson M, Hours M, et al. Pregnancy and multiple sclerosis (the PRIMS study): clinical predictors of post-partum relapse. Brain. 2004;127(Pt 6):1353-1360. doi:10.1093/brain/awh152
4. Gavoille A, Leray E, Marignier R, et al. Sex-Related Gap in the Use of Disease-Modifying Therapies in Multiple Sclerosis. Neurology. 2025;105(4):e213907. doi:10.1212/WNL.0000000000213907
5. Vukusic S, Carra-Dalliere C, Ciron J, et al. Pregnancy and multiple sclerosis: 2022 recommendations from the French multiple sclerosis society. Mult Scler. 2023;29(1):11-36. doi:10.1177/13524585221129472