Contributions
Abstract: P999
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Progressive MS
Background: Relapse rates during pregnancy and post-partum period have been studied extensively, but we lack data on impact of pregnancy on progressive phase of MS. Such data is important from biologic standpoint as well as for purposes of counseling women with progressive MS, who are interested in becoming pregnant.
Objectives: To compare post-partum disability progression and relapse rate in women with progressive MS and propensity-score matched patients without pregnancy during follow-up.
Methods: We identified all women in the MSBase Registry with progressive MS at the time of pregnancy; a live birth; ≥1 EDSS within 24 months prior to pregnancy; ≥2 years post-delivery follow-up. Patients were matched 1:2 on age, disease duration, disease subtype, disability (EDSS) and proportion of time on DMT with women who did not become pregnant during follow up. Baseline was defined as time of delivery for women who were pregnant and as date of contemporaneous EDSS assessment at which they satisfied the inclusion criteria for non-pregnant patients. Hazard ration of disability progression was calculated using marginal Cox model; p< 0.05 was considered significant.
Results: Pregnancy was recorded for 55 women in the MSBase with secondary-progressive (N=49) or primary-progressive (N=6) MS at the time of conception. Mean age (interquartile range) at baseline was 31.6 (28.4, 34.7) years; disease duration - 7.8 (4.5, 13.3) years; EDSS - 2.5 (1.5, 5). These patients were successfully propensity-score matched 1:2 with women with secondary progressive (N=100) or primary-progressive (N=10) MS, but no pregnancy. Hazard ration (HR) for time to three-month confirmed disability progression was lower among women who become pregnant compared to those who did not (incidence/100 person-years was 10.62 (95% CI, 7.76, 14.53) for pregnant group v. 17.97 (14.56, 22.17) for non-pregnant group; HR 0.67 (0.47, 0.97); p=0.036). Relapse rates, calculated in 6 months intervals for 24 months after baseline, were similar in both groups, though there was a trend toward higher relapse rate among pregnant group in the first 6 months post-baseline (delivery) (p=0.15).
Conclusions: Women who became pregnant during progressive phase had lower hazard of disability progression as compared to those who did not become pregnant. Whether this is due to neuroprotective effect of pregnancy will require additional studies.
Disclosure: No targeted funding was provided for this study. MSBase Foundation is a not-for- profit
organization that receives support from Bayer Schering, Biogen Idec, Merck Serono, Novartis Pharma,and Sanofi. Ilya Kister: nothing to disclose
Ilya Kister served on scientific advisory board for Biogen Idec and Genentech, and received research support from Guthy-Jackson Charitable Foundation, National Multiple Sclerosis Society, Biogen-Idec, Serono, Genzyme and Novartis.Tim Spelman received compensation for serving on scientific advisory boards, honoraria for consultancy and funding for travel from Biogen Inc; speaker honoraria from Novartis.
Pierre Duquette has received honoraria for organising CME events and has obtained funding to attend meetings from Biogen Idec, EMD Serono, TEVA Neuroscience, Novartis, and Genzyme, has received funding for investigator-initiated trials with Biogen Idec, EMD Serono, Genzyme, and Novartis, and has received peer-review funding from CIHR and from the MS Society of Canada.
Scientific Advisory Board and speaker honoraria: Biogen, Genzyme, EMD Serono, Teva Canada Innovation and Novartis
MT has served on scientific Advisory Boards for Biogen, Novartis, Almirall, Roche and Genzyme; has received speaker honoraria from Biogen-Idec, Sanofi Aventis, Merck-Serono, Teva, Genzyme, Almirall and Novartis; has received research grants for her Institution from Biogen-Idec, Merck-Serono and Novartis.
Guillermo Izquierdo received consulting fees from Bayer Schering, Biogen Idec, Merck Serono, Novartis, Sanofi, and Teva.
Dr. Roberto Bergamaschi has served on scientific advisory boards for Biogen Idec and Almirall; has received honoraria for speaking from Bayer Schering, Biogen Idec, Genzyme, Merck Serono, Novartis, Sanofi-Aventis, Teva; has received funding for congress and travel/accommodation expenses for scientific meetings from Sanofi-Aventis, Genzyme, Biogen Idec, Bayer Schering, Teva, Merck Serono, Almirall, and Novartis; has received research grants from Merck Serono, Biogen Idec, Teva, Bayer Schering, Novartis, Sanofi-Aventis, Genzyme
Advisory board : Biogen Idec, Merk-Serono, Genzyme, Novartis; Lectures, teaching events: Teva neuroscience, Merk-Serono, Genzyme, Biogen idec, Bayer; Research trial: Biogen Idec, Sanofi-Avantis, MSBase, EMD-Serono
EP served on scientific advisory boards for Merck Serono, Genzyme and Biogen; he has received honoraria and travel grants from Sanofi, Novartis, Biogen, Merck Serono, Genzyme and Teva.
Francois Grand"Maison received honoraria or research funding from Biogen Idec, Chugai, Opexa, Genzyme, Novartis and Actelion.
Raymond Hupperts received honoraria as consultant on scientific advisory boards from Merck-Serono, Biogen-Idec, Genzyme-Sanofi and Teva, research funding from Merck-Serono and Biogen-Idec, and speaker honoraria from Sanofi-Genzyme and Novartis.
Gerardo Iuliano had travel/accommodations/meeting expenses funded by Bayer Schering, Biogen Idec, Merck Serono, Novartis, Sanofi Aventis, and Teva.
F. Granella has served on scientific advisory boards for Biogen Idec, Novartis and Sanofi Aventis and has received funding for travel and speaker honoraria from Biogen Idec, Merck Serono, and Almirall
Celia Oreja-Guevara received honoraria as speaker from Biogen-Idec, Bayer-Schering, Merck-Serono, Teva, Genzyme and Novartis.
VGJ has received conference travel support from Merck and Novartis; and speakers honoraria from Novartis and Biogen.
H Butzkueven has received consulting fees from Genzyme, Biogen, Novartis, Merck and Oxford PharmaGenesis; and grant/research support from Biogen, Novartis, Merck and Genzyme
Abstract: P999
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Progressive MS
Background: Relapse rates during pregnancy and post-partum period have been studied extensively, but we lack data on impact of pregnancy on progressive phase of MS. Such data is important from biologic standpoint as well as for purposes of counseling women with progressive MS, who are interested in becoming pregnant.
Objectives: To compare post-partum disability progression and relapse rate in women with progressive MS and propensity-score matched patients without pregnancy during follow-up.
Methods: We identified all women in the MSBase Registry with progressive MS at the time of pregnancy; a live birth; ≥1 EDSS within 24 months prior to pregnancy; ≥2 years post-delivery follow-up. Patients were matched 1:2 on age, disease duration, disease subtype, disability (EDSS) and proportion of time on DMT with women who did not become pregnant during follow up. Baseline was defined as time of delivery for women who were pregnant and as date of contemporaneous EDSS assessment at which they satisfied the inclusion criteria for non-pregnant patients. Hazard ration of disability progression was calculated using marginal Cox model; p< 0.05 was considered significant.
Results: Pregnancy was recorded for 55 women in the MSBase with secondary-progressive (N=49) or primary-progressive (N=6) MS at the time of conception. Mean age (interquartile range) at baseline was 31.6 (28.4, 34.7) years; disease duration - 7.8 (4.5, 13.3) years; EDSS - 2.5 (1.5, 5). These patients were successfully propensity-score matched 1:2 with women with secondary progressive (N=100) or primary-progressive (N=10) MS, but no pregnancy. Hazard ration (HR) for time to three-month confirmed disability progression was lower among women who become pregnant compared to those who did not (incidence/100 person-years was 10.62 (95% CI, 7.76, 14.53) for pregnant group v. 17.97 (14.56, 22.17) for non-pregnant group; HR 0.67 (0.47, 0.97); p=0.036). Relapse rates, calculated in 6 months intervals for 24 months after baseline, were similar in both groups, though there was a trend toward higher relapse rate among pregnant group in the first 6 months post-baseline (delivery) (p=0.15).
Conclusions: Women who became pregnant during progressive phase had lower hazard of disability progression as compared to those who did not become pregnant. Whether this is due to neuroprotective effect of pregnancy will require additional studies.
Disclosure: No targeted funding was provided for this study. MSBase Foundation is a not-for- profit
organization that receives support from Bayer Schering, Biogen Idec, Merck Serono, Novartis Pharma,and Sanofi. Ilya Kister: nothing to disclose
Ilya Kister served on scientific advisory board for Biogen Idec and Genentech, and received research support from Guthy-Jackson Charitable Foundation, National Multiple Sclerosis Society, Biogen-Idec, Serono, Genzyme and Novartis.Tim Spelman received compensation for serving on scientific advisory boards, honoraria for consultancy and funding for travel from Biogen Inc; speaker honoraria from Novartis.
Pierre Duquette has received honoraria for organising CME events and has obtained funding to attend meetings from Biogen Idec, EMD Serono, TEVA Neuroscience, Novartis, and Genzyme, has received funding for investigator-initiated trials with Biogen Idec, EMD Serono, Genzyme, and Novartis, and has received peer-review funding from CIHR and from the MS Society of Canada.
Scientific Advisory Board and speaker honoraria: Biogen, Genzyme, EMD Serono, Teva Canada Innovation and Novartis
MT has served on scientific Advisory Boards for Biogen, Novartis, Almirall, Roche and Genzyme; has received speaker honoraria from Biogen-Idec, Sanofi Aventis, Merck-Serono, Teva, Genzyme, Almirall and Novartis; has received research grants for her Institution from Biogen-Idec, Merck-Serono and Novartis.
Guillermo Izquierdo received consulting fees from Bayer Schering, Biogen Idec, Merck Serono, Novartis, Sanofi, and Teva.
Dr. Roberto Bergamaschi has served on scientific advisory boards for Biogen Idec and Almirall; has received honoraria for speaking from Bayer Schering, Biogen Idec, Genzyme, Merck Serono, Novartis, Sanofi-Aventis, Teva; has received funding for congress and travel/accommodation expenses for scientific meetings from Sanofi-Aventis, Genzyme, Biogen Idec, Bayer Schering, Teva, Merck Serono, Almirall, and Novartis; has received research grants from Merck Serono, Biogen Idec, Teva, Bayer Schering, Novartis, Sanofi-Aventis, Genzyme
Advisory board : Biogen Idec, Merk-Serono, Genzyme, Novartis; Lectures, teaching events: Teva neuroscience, Merk-Serono, Genzyme, Biogen idec, Bayer; Research trial: Biogen Idec, Sanofi-Avantis, MSBase, EMD-Serono
EP served on scientific advisory boards for Merck Serono, Genzyme and Biogen; he has received honoraria and travel grants from Sanofi, Novartis, Biogen, Merck Serono, Genzyme and Teva.
Francois Grand"Maison received honoraria or research funding from Biogen Idec, Chugai, Opexa, Genzyme, Novartis and Actelion.
Raymond Hupperts received honoraria as consultant on scientific advisory boards from Merck-Serono, Biogen-Idec, Genzyme-Sanofi and Teva, research funding from Merck-Serono and Biogen-Idec, and speaker honoraria from Sanofi-Genzyme and Novartis.
Gerardo Iuliano had travel/accommodations/meeting expenses funded by Bayer Schering, Biogen Idec, Merck Serono, Novartis, Sanofi Aventis, and Teva.
F. Granella has served on scientific advisory boards for Biogen Idec, Novartis and Sanofi Aventis and has received funding for travel and speaker honoraria from Biogen Idec, Merck Serono, and Almirall
Celia Oreja-Guevara received honoraria as speaker from Biogen-Idec, Bayer-Schering, Merck-Serono, Teva, Genzyme and Novartis.
VGJ has received conference travel support from Merck and Novartis; and speakers honoraria from Novartis and Biogen.
H Butzkueven has received consulting fees from Genzyme, Biogen, Novartis, Merck and Oxford PharmaGenesis; and grant/research support from Biogen, Novartis, Merck and Genzyme