Background: Exposure to disease-modifying therapy (DMT) during early pregnancy in women with relapsing-remitting MS (RAMS) may be increasing.Objective: To retrospectively determine incidence of pregnancy, DMT exposure and pregnancy outcomes in women with RAMS.Methods: We identified all women with RAMS 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.

Incidence of pregnancy and disease-modifying therapy exposure trends in women with multiple sclerosis: A contemporary cohort study / Nguyen, A. -L.; Havrdova, E. K.; Horakova, D.; Izquierdo, G.; Kalincik, T.; van der Walt, A.; Terzi, M.; Alroughani, R.; Duquette, P.; Girard, M.; Prat, A.; Boz, C.; Sola, P.; Ferraro, D.; Lugaresi, A.; Lechner-Scott, J.; Barnett, M.; Grand'Maison, F.; Grammond, P.; Ramo-Tello, C.; Turkoglu, R.; Mccombe, P.; Pucci, E.; Trojano, M.; Granella, F.; Spitaleri, D.; Van Pesch, V.; Soysal, A.; Oreja-Guevara, C.; Verheul, F.; Vucic, S.; Hodgkinson, S.; Slee, M.; Ampapa, R.; Prevost, J.; Menoyo, J. L. S.; Skibina, O.; Solaro, C.; Olascoaga, J.; Shaw, C.; Madsen, K. G.; Naidoo, K.; Hyde, R.; Butzkueven, H.; Jokubaitis, V.. - In: MULTIPLE SCLEROSIS AND RELATED DISORDERS. - ISSN 2211-0348. - 28:(2019), pp. 235-243. [10.1016/j.msard.2019.01.003]

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

Granella F.;
2019-01-01

Abstract

Background: Exposure to disease-modifying therapy (DMT) during early pregnancy in women with relapsing-remitting MS (RAMS) may be increasing.Objective: To retrospectively determine incidence of pregnancy, DMT exposure and pregnancy outcomes in women with RAMS.Methods: We identified all women with RAMS 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.
2019
Incidence of pregnancy and disease-modifying therapy exposure trends in women with multiple sclerosis: A contemporary cohort study / Nguyen, A. -L.; Havrdova, E. K.; Horakova, D.; Izquierdo, G.; Kalincik, T.; van der Walt, A.; Terzi, M.; Alroughani, R.; Duquette, P.; Girard, M.; Prat, A.; Boz, C.; Sola, P.; Ferraro, D.; Lugaresi, A.; Lechner-Scott, J.; Barnett, M.; Grand'Maison, F.; Grammond, P.; Ramo-Tello, C.; Turkoglu, R.; Mccombe, P.; Pucci, E.; Trojano, M.; Granella, F.; Spitaleri, D.; Van Pesch, V.; Soysal, A.; Oreja-Guevara, C.; Verheul, F.; Vucic, S.; Hodgkinson, S.; Slee, M.; Ampapa, R.; Prevost, J.; Menoyo, J. L. S.; Skibina, O.; Solaro, C.; Olascoaga, J.; Shaw, C.; Madsen, K. G.; Naidoo, K.; Hyde, R.; Butzkueven, H.; Jokubaitis, V.. - In: MULTIPLE SCLEROSIS AND RELATED DISORDERS. - ISSN 2211-0348. - 28:(2019), pp. 235-243. [10.1016/j.msard.2019.01.003]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11381/2866811
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