Incidence of pregnancy and disease-modifying therapy exposure trends in women with multiple sclerosis: A contemporary cohort study

MSBase Study Group

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Exposure to disease-modifying therapy (DMT) during early pregnancy in women with relapsing-remitting MS (RRMS) may be increasing. Objective: To retrospectively determine incidence of pregnancy, DMT exposure and pregnancy outcomes in women with RRMS. Methods: We identified all women with RRMS aged 15–45 years in the MSBase Registry between 2005–2016. Annualised pregnancy incidence rates were calculated using Poisson regression models. DMT exposures and pregnancy outcomes were assessed. Results: Of 9,098 women meeting inclusion criteria, 1,178 (13%) women recorded 1,521 pregnancies. The annualised incidence rate of pregnancy was 0.042 (95% CI 0.040, 0.045). A total of 635 (42%) reported pregnancies were conceived on DMT, increasing from 27% in 2006 to 62% in 2016. The median duration of DMT exposure during pregnancy was 30 days (IQR: 9, 50). There were a higher number of induced abortions on FDA pregnancy class C/D drugs compared with pregnancy class B and no DMT (p = 0.010); but no differences in spontaneous abortions, term or preterm births. Conclusions: We report low pregnancy incidence rates, with increasing number of pregnancies conceived on DMT over the past 12-years. The median duration of DMT exposure in pregnancy was relatively short at one month.

Original languageEnglish
Pages (from-to)235-243
Number of pages9
JournalMultiple Sclerosis and Related Disorders
Volume28
DOIs
Publication statusPublished - Feb 1 2019

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Implosive Therapy
Multiple Sclerosis
Cohort Studies
Pregnancy
Incidence
Pregnancy Rate
Pregnancy Outcome
Term Birth
Induced Abortion
Premature Birth
Spontaneous Abortion
Therapeutics
Registries

Keywords

  • Incidence
  • Multiple sclerosis
  • Outcomes
  • Pregnancy
  • Therapy

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

@article{a2902e3d03a443cfa5e4d8b32ec2da97,
title = "Incidence of pregnancy and disease-modifying therapy exposure trends in women with multiple sclerosis: A contemporary cohort study",
abstract = "Background: Exposure to disease-modifying therapy (DMT) during early pregnancy in women with relapsing-remitting MS (RRMS) may be increasing. Objective: To retrospectively determine incidence of pregnancy, DMT exposure and pregnancy outcomes in women with RRMS. Methods: We identified all women with RRMS aged 15–45 years in the MSBase Registry between 2005–2016. Annualised pregnancy incidence rates were calculated using Poisson regression models. DMT exposures and pregnancy outcomes were assessed. Results: Of 9,098 women meeting inclusion criteria, 1,178 (13{\%}) women recorded 1,521 pregnancies. The annualised incidence rate of pregnancy was 0.042 (95{\%} CI 0.040, 0.045). A total of 635 (42{\%}) reported pregnancies were conceived on DMT, increasing from 27{\%} in 2006 to 62{\%} in 2016. The median duration of DMT exposure during pregnancy was 30 days (IQR: 9, 50). There were a higher number of induced abortions on FDA pregnancy class C/D drugs compared with pregnancy class B and no DMT (p = 0.010); but no differences in spontaneous abortions, term or preterm births. Conclusions: We report low pregnancy incidence rates, with increasing number of pregnancies conceived on DMT over the past 12-years. The median duration of DMT exposure in pregnancy was relatively short at one month.",
keywords = "Incidence, Multiple sclerosis, Outcomes, Pregnancy, Therapy",
author = "{MSBase Study Group} and Nguyen, {Ai Lan} and Havrdova, {Eva Kubala} and Dana Horakova and Guillermo Izquierdo and Tomas Kalincik and {van der Walt}, Anneke and Murat Terzi and Raed Alroughani and Pierre Duquette and Marc Girard and Alexandre Prat and Cavit Boz and Patrizia Sola and Diana Ferraro and Alessandra Lugaresi and Jeannette Lechner-Scott and Michael Barnett and Francois Grand'Maison and Pierre Grammond and Cristina Ramo-Tello and Recai Turkoglu and Pamela McCombe and Eugenio Pucci and Maria Trojano and Franco Granella and Daniele Spitaleri and {Van Pesch}, Vincent and Aysun Soysal and Celia Oreja-Guevara and Freek Verheul and Steve Vucic and Suzanne Hodgkinson and Mark Slee and Radek Ampapa and Julie Prevost and Menoyo, {Jose Luis Sanchez} and Olga Skibina and Claudio Solaro and Javier Olascoaga and Cameron Shaw and Madsen, {Klaus Gregaard} and Kerisha Naidoo and Robert Hyde and Helmut Butzkueven and Vilija Jokubaitis",
note = "Ricercatore distaccato presso IRCCS a seguito Convenzione esclusiva con Universit{\`a} di Bologna (Lugaresi Alessandra)",
year = "2019",
month = "2",
day = "1",
doi = "10.1016/j.msard.2019.01.003",
language = "English",
volume = "28",
pages = "235--243",
journal = "Multiple Sclerosis and Related Disorders",
issn = "2211-0348",
publisher = "Elsevier",

}

TY - JOUR

T1 - Incidence of pregnancy and disease-modifying therapy exposure trends in women with multiple sclerosis

T2 - A contemporary cohort study

AU - MSBase Study Group

AU - Nguyen, Ai Lan

AU - Havrdova, Eva Kubala

AU - Horakova, Dana

AU - Izquierdo, Guillermo

AU - Kalincik, Tomas

AU - van der Walt, Anneke

AU - Terzi, Murat

AU - Alroughani, Raed

AU - Duquette, Pierre

AU - Girard, Marc

AU - Prat, Alexandre

AU - Boz, Cavit

AU - Sola, Patrizia

AU - Ferraro, Diana

AU - Lugaresi, Alessandra

AU - Lechner-Scott, Jeannette

AU - Barnett, Michael

AU - Grand'Maison, Francois

AU - Grammond, Pierre

AU - Ramo-Tello, Cristina

AU - Turkoglu, Recai

AU - McCombe, Pamela

AU - Pucci, Eugenio

AU - Trojano, Maria

AU - Granella, Franco

AU - Spitaleri, Daniele

AU - Van Pesch, Vincent

AU - Soysal, Aysun

AU - Oreja-Guevara, Celia

AU - Verheul, Freek

AU - Vucic, Steve

AU - Hodgkinson, Suzanne

AU - Slee, Mark

AU - Ampapa, Radek

AU - Prevost, Julie

AU - Menoyo, Jose Luis Sanchez

AU - Skibina, Olga

AU - Solaro, Claudio

AU - Olascoaga, Javier

AU - Shaw, Cameron

AU - Madsen, Klaus Gregaard

AU - Naidoo, Kerisha

AU - Hyde, Robert

AU - Butzkueven, Helmut

AU - Jokubaitis, Vilija

N1 - Ricercatore distaccato presso IRCCS a seguito Convenzione esclusiva con Università di Bologna (Lugaresi Alessandra)

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Background: Exposure to disease-modifying therapy (DMT) during early pregnancy in women with relapsing-remitting MS (RRMS) may be increasing. Objective: To retrospectively determine incidence of pregnancy, DMT exposure and pregnancy outcomes in women with RRMS. Methods: We identified all women with RRMS aged 15–45 years in the MSBase Registry between 2005–2016. Annualised pregnancy incidence rates were calculated using Poisson regression models. DMT exposures and pregnancy outcomes were assessed. Results: Of 9,098 women meeting inclusion criteria, 1,178 (13%) women recorded 1,521 pregnancies. The annualised incidence rate of pregnancy was 0.042 (95% CI 0.040, 0.045). A total of 635 (42%) reported pregnancies were conceived on DMT, increasing from 27% in 2006 to 62% in 2016. The median duration of DMT exposure during pregnancy was 30 days (IQR: 9, 50). There were a higher number of induced abortions on FDA pregnancy class C/D drugs compared with pregnancy class B and no DMT (p = 0.010); but no differences in spontaneous abortions, term or preterm births. Conclusions: We report low pregnancy incidence rates, with increasing number of pregnancies conceived on DMT over the past 12-years. The median duration of DMT exposure in pregnancy was relatively short at one month.

AB - Background: Exposure to disease-modifying therapy (DMT) during early pregnancy in women with relapsing-remitting MS (RRMS) may be increasing. Objective: To retrospectively determine incidence of pregnancy, DMT exposure and pregnancy outcomes in women with RRMS. Methods: We identified all women with RRMS aged 15–45 years in the MSBase Registry between 2005–2016. Annualised pregnancy incidence rates were calculated using Poisson regression models. DMT exposures and pregnancy outcomes were assessed. Results: Of 9,098 women meeting inclusion criteria, 1,178 (13%) women recorded 1,521 pregnancies. The annualised incidence rate of pregnancy was 0.042 (95% CI 0.040, 0.045). A total of 635 (42%) reported pregnancies were conceived on DMT, increasing from 27% in 2006 to 62% in 2016. The median duration of DMT exposure during pregnancy was 30 days (IQR: 9, 50). There were a higher number of induced abortions on FDA pregnancy class C/D drugs compared with pregnancy class B and no DMT (p = 0.010); but no differences in spontaneous abortions, term or preterm births. Conclusions: We report low pregnancy incidence rates, with increasing number of pregnancies conceived on DMT over the past 12-years. The median duration of DMT exposure in pregnancy was relatively short at one month.

KW - Incidence

KW - Multiple sclerosis

KW - Outcomes

KW - Pregnancy

KW - Therapy

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U2 - 10.1016/j.msard.2019.01.003

DO - 10.1016/j.msard.2019.01.003

M3 - Article

C2 - 30623864

AN - SCOPUS:85059560505

VL - 28

SP - 235

EP - 243

JO - Multiple Sclerosis and Related Disorders

JF - Multiple Sclerosis and Related Disorders

SN - 2211-0348

ER -