Contributions
Abstract: P324
Type: Poster
Abstract Category: Clinical aspects of MS - MS and gender
Background: Pregnancy is a period of relative disease quiescence for a majority of women with multiple sclerosis (MS). Though the use of disease modifying therapies (DMTs) is discouraged during pregnancy, specific recommendations with respect to breastfeeding or timing of cessation of DMT use as well as re-initiation of DMT postpartum are often unclear.
Objective: Our primary objective is to examine the pregnancy-making decisions of women with MS enrolled in the New York State MS Consortium (NYSMSC) and the associations with clinical outcomes.
Methods: 800 women enrolled in the NYSMSC were mailed a questionnaire inquiring on reproductive history and reproductive decision-making. Longitudinally collected information including demographics, disease characteristics (MS type, relapses), EDSS, DMT history, and patient-reported outcomes are available from the 20-year ongoing prospective NYSMSC registry.
Results: To date, 477 questionnaires have been received. Of the 365 women who responded to specific pregnancy questions, 97 (26.6%) reported at least one pregnancy or pregnancy attempt after diagnosis of MS. Of those who attempted pregnancy post-MS diagnosis, 64 (66%) reported at least one successful pregnancy, while 21 (21.7%) reported that they were unable to conceive, and several were still trying. The majority of women (61.1%) resumed the same DMT they had been taking before their pregnancy, and 65.4% resumed DMT use within 6 months of delivery. Ten women (10.3%) reported relapses during pregnancy. There were no significant differences in age or DMT use between women who reported relapses and women who did not. Women who reported relapses during pregnancy were also more likely to report relapses in the 12 months prior to the pregnancy (p=0.020). Sixteen women reported a relapse in the 12 months before pregnancy; of those, 11 (68.8%) also reported relapses in the 12 months after pregnancy. Of the 55 women who did not have a relapse in the 12 months before pregnancy; 15 (29.1%) reported having a relapse in the 12 months after pregnancy. The difference between the two groups was significant (p-value=0.004).
Conclusion: A substantial portion of women with MS will intend to become pregnant after their MS diagnosis. As such, it is essential that evidence-based information is available to young women with MS. Additional analyses will be presented in a larger sample with respect to the effect and type of DMT used before and after pregnancy on relapses.
Disclosure:
Caila Vaughn: Nothing to disclose.
Katelyn Kavak: Nothing to disclose.
Muhammad Nadeem: Nothing to disclose.
Karen Zakalik: Nothing to disclose.
Barbara Teter has received grant and/or research support from Biogen Idec, Teva Neuroscience, EMD Serono, Avanir, Genzyme and Novartis.
Patricia Coyle receives consulting fees from AbbVie, Accordant, Acorda, Bayer, Biogen, Genentech/Roche, Genzyme/Sanofi, Mallinckrodt, Novartis, Serono, and Teva and she also receives research support from Actelion, Genentech/Roche, NINDS, Novartis, and Opexa.
Lauren Krupp has received either consulting fees, honoraria, or royalty payments from Biogen, Pfizer, Teva Neurosciences, EMD Serono, Janseen, Novartis and Abbvie, and has received research funding from Novartis, Teva Neurosciences, the National Multiple Sclerosis Society, the Department of Defense, the national Institutes of Health and the Lourie Foundation.
Megan Hyland´s employer, the University of Rochester, has received research support from Novartis and Chugai.
Burk Jubelt has received compensation for patient education speaking for the National Multiple Sclerosis Society and Multiple Sclerosis Resources of Central New York, he has performed CME for CMEducation Resources LLC and Prime Education, Inc. and has received research support from Sanofi-Aventis, Genzyme, Novartis, Grifols, Receptos, Biogen-Idec, NY Stem Cell Program and Nih/NINDS.
Malcolm Gottesman has served as a consultand for Biogen, Teva and Genzyme.
Keith Edwards has received fees for consulting servies from Biogen and Genzyme, has performed in speaker bureaus for Biogen and Genzyme and has received research support from Actelion, Biogen, Eisai, Eli Lilly, Forum Pharmaceuticals, Genentech, Genzyme/Sanofi, Hoffman-La Roche, Merz Pharmaceuticals, Novartis, Pfizer and Vaccinex.
Bianca Weinstock-Guttman has received personal compensation for consulting, speaking and serving on a scientific advisory board for Biogen Idec, Teva Neuroscience, EMD Serono, Novartis, Questcor and Genzyme& Sanofi and has received financial support for research activities from NMSS, NIH (not for the present study), ITN, Teva Neuroscience, Biogen Idec, EMD Serono, Aspreva, Novartis, Genzyme.
This study has been funded by Teva Pharmaceuticals.
Abstract: P324
Type: Poster
Abstract Category: Clinical aspects of MS - MS and gender
Background: Pregnancy is a period of relative disease quiescence for a majority of women with multiple sclerosis (MS). Though the use of disease modifying therapies (DMTs) is discouraged during pregnancy, specific recommendations with respect to breastfeeding or timing of cessation of DMT use as well as re-initiation of DMT postpartum are often unclear.
Objective: Our primary objective is to examine the pregnancy-making decisions of women with MS enrolled in the New York State MS Consortium (NYSMSC) and the associations with clinical outcomes.
Methods: 800 women enrolled in the NYSMSC were mailed a questionnaire inquiring on reproductive history and reproductive decision-making. Longitudinally collected information including demographics, disease characteristics (MS type, relapses), EDSS, DMT history, and patient-reported outcomes are available from the 20-year ongoing prospective NYSMSC registry.
Results: To date, 477 questionnaires have been received. Of the 365 women who responded to specific pregnancy questions, 97 (26.6%) reported at least one pregnancy or pregnancy attempt after diagnosis of MS. Of those who attempted pregnancy post-MS diagnosis, 64 (66%) reported at least one successful pregnancy, while 21 (21.7%) reported that they were unable to conceive, and several were still trying. The majority of women (61.1%) resumed the same DMT they had been taking before their pregnancy, and 65.4% resumed DMT use within 6 months of delivery. Ten women (10.3%) reported relapses during pregnancy. There were no significant differences in age or DMT use between women who reported relapses and women who did not. Women who reported relapses during pregnancy were also more likely to report relapses in the 12 months prior to the pregnancy (p=0.020). Sixteen women reported a relapse in the 12 months before pregnancy; of those, 11 (68.8%) also reported relapses in the 12 months after pregnancy. Of the 55 women who did not have a relapse in the 12 months before pregnancy; 15 (29.1%) reported having a relapse in the 12 months after pregnancy. The difference between the two groups was significant (p-value=0.004).
Conclusion: A substantial portion of women with MS will intend to become pregnant after their MS diagnosis. As such, it is essential that evidence-based information is available to young women with MS. Additional analyses will be presented in a larger sample with respect to the effect and type of DMT used before and after pregnancy on relapses.
Disclosure:
Caila Vaughn: Nothing to disclose.
Katelyn Kavak: Nothing to disclose.
Muhammad Nadeem: Nothing to disclose.
Karen Zakalik: Nothing to disclose.
Barbara Teter has received grant and/or research support from Biogen Idec, Teva Neuroscience, EMD Serono, Avanir, Genzyme and Novartis.
Patricia Coyle receives consulting fees from AbbVie, Accordant, Acorda, Bayer, Biogen, Genentech/Roche, Genzyme/Sanofi, Mallinckrodt, Novartis, Serono, and Teva and she also receives research support from Actelion, Genentech/Roche, NINDS, Novartis, and Opexa.
Lauren Krupp has received either consulting fees, honoraria, or royalty payments from Biogen, Pfizer, Teva Neurosciences, EMD Serono, Janseen, Novartis and Abbvie, and has received research funding from Novartis, Teva Neurosciences, the National Multiple Sclerosis Society, the Department of Defense, the national Institutes of Health and the Lourie Foundation.
Megan Hyland´s employer, the University of Rochester, has received research support from Novartis and Chugai.
Burk Jubelt has received compensation for patient education speaking for the National Multiple Sclerosis Society and Multiple Sclerosis Resources of Central New York, he has performed CME for CMEducation Resources LLC and Prime Education, Inc. and has received research support from Sanofi-Aventis, Genzyme, Novartis, Grifols, Receptos, Biogen-Idec, NY Stem Cell Program and Nih/NINDS.
Malcolm Gottesman has served as a consultand for Biogen, Teva and Genzyme.
Keith Edwards has received fees for consulting servies from Biogen and Genzyme, has performed in speaker bureaus for Biogen and Genzyme and has received research support from Actelion, Biogen, Eisai, Eli Lilly, Forum Pharmaceuticals, Genentech, Genzyme/Sanofi, Hoffman-La Roche, Merz Pharmaceuticals, Novartis, Pfizer and Vaccinex.
Bianca Weinstock-Guttman has received personal compensation for consulting, speaking and serving on a scientific advisory board for Biogen Idec, Teva Neuroscience, EMD Serono, Novartis, Questcor and Genzyme& Sanofi and has received financial support for research activities from NMSS, NIH (not for the present study), ITN, Teva Neuroscience, Biogen Idec, EMD Serono, Aspreva, Novartis, Genzyme.
This study has been funded by Teva Pharmaceuticals.