Contributions
Abstract: EP1359
Type: ePoster
Abstract Category: Clinical aspects of MS - 6 MS and gender
Background: Multiple sclerosis (MS) predominantly affects females, with clinical onset during the childbearing years. In MS patients, assisted reproduction treatment (ART) may significantly increase the risk for a relapse. However, whether ART is related to relapse in Japanese patients with MS is unclear.
Objective: To determine the pregnancy outcome and whether Japanese patients with MS have an increased risk of relapse after ART.
Subjects and methods: We studied five Japanese patients in our hospital with relapsing-remitting MS (RRMS) who were treated with ART and five RRMS patients who became pregnant naturally. All patients received disease-modifying drugs. The relationship between ART and relapse occurrence was analyzed. Peripheral blood lymphocyte subsets were analyzed by flow cytometry. Pregnant patients treated with ART were compared to patients who became pregnant naturally. We studied the CD4+CXCR3/CD4+CCR4 ratio, CD8+CXCR3/CD8+CCR4 ratio, natural killer (NK) cells, and regulatory
T cells before and during pregnancy, after delivery, and after failed ART.
Results: Four patients treated with ART became pregnant and delivered a baby, and one patients experienced a missed abortion. No patients used GnRH for ART. No relapses occurred in the year prior to ART, during pregnancy, or after delivery in patients with successful pregnancies. However, the RRMS patient who miscarried after IVF relapsed prior to ART and 2 months after the miscarriage. Peripheral blood lymphocyte subsets were not significantly different between patients treated with ART or not. The patient who failed IVF had increased NK cells at the time of abortion and a relapse compared with patients who became pregnant with/without ART.
Conclusion: No increase in relapses occurred in association with ART in patients with RRMS with stable disease activity. ART-related relapses may be associated with relapses in the year prior to ART and after failed IVF. Increased NK cells may be a cause of ART failure and relapse.
Disclosure:
YS has received honoraria for talks from Bayer Yakuhin, and has received personal compensation for consulting services from Biogen Idec Japan, Teijin Pharma, Takeda Pharmaceutical Company and Novartis Pharma.
RI and KK have no conflicts of interest to declare. This work was supported by a Health and Labour Sciences Research Grant on Intractable Diseases (Evidence-based Early Diagnosis and Treatment Strategies for Neuroimmunological Diseases) from the Ministry of Health, Labour and Welfare of Japan.
Abstract: EP1359
Type: ePoster
Abstract Category: Clinical aspects of MS - 6 MS and gender
Background: Multiple sclerosis (MS) predominantly affects females, with clinical onset during the childbearing years. In MS patients, assisted reproduction treatment (ART) may significantly increase the risk for a relapse. However, whether ART is related to relapse in Japanese patients with MS is unclear.
Objective: To determine the pregnancy outcome and whether Japanese patients with MS have an increased risk of relapse after ART.
Subjects and methods: We studied five Japanese patients in our hospital with relapsing-remitting MS (RRMS) who were treated with ART and five RRMS patients who became pregnant naturally. All patients received disease-modifying drugs. The relationship between ART and relapse occurrence was analyzed. Peripheral blood lymphocyte subsets were analyzed by flow cytometry. Pregnant patients treated with ART were compared to patients who became pregnant naturally. We studied the CD4+CXCR3/CD4+CCR4 ratio, CD8+CXCR3/CD8+CCR4 ratio, natural killer (NK) cells, and regulatory
T cells before and during pregnancy, after delivery, and after failed ART.
Results: Four patients treated with ART became pregnant and delivered a baby, and one patients experienced a missed abortion. No patients used GnRH for ART. No relapses occurred in the year prior to ART, during pregnancy, or after delivery in patients with successful pregnancies. However, the RRMS patient who miscarried after IVF relapsed prior to ART and 2 months after the miscarriage. Peripheral blood lymphocyte subsets were not significantly different between patients treated with ART or not. The patient who failed IVF had increased NK cells at the time of abortion and a relapse compared with patients who became pregnant with/without ART.
Conclusion: No increase in relapses occurred in association with ART in patients with RRMS with stable disease activity. ART-related relapses may be associated with relapses in the year prior to ART and after failed IVF. Increased NK cells may be a cause of ART failure and relapse.
Disclosure:
YS has received honoraria for talks from Bayer Yakuhin, and has received personal compensation for consulting services from Biogen Idec Japan, Teijin Pharma, Takeda Pharmaceutical Company and Novartis Pharma.
RI and KK have no conflicts of interest to declare. This work was supported by a Health and Labour Sciences Research Grant on Intractable Diseases (Evidence-based Early Diagnosis and Treatment Strategies for Neuroimmunological Diseases) from the Ministry of Health, Labour and Welfare of Japan.