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

Ai Lan Nguyen, Eva Kubala Havrdova, Dana Horakova, Guillermo Izquierdo, Tomas Kalincik, Anneke van der Walt, Murat Terzi, Raed Alroughani, Pierre Duquette, Marc Girard, Alexandre Prat, Cavit Boz, Patrizia Sola, Diana Ferraro, Alessandra Lugaresi, Jeannette Lechner-Scott, Michael Barnett, Francois Grand'Maison, Pierre Grammond, Cristina Ramo-Tello & 26 others Recai Turkoglu, Pamela McCombe, Eugenio Pucci, Maria Trojano, Franco Granella, Daniele Spitaleri, Vincent Van Pesch, Aysun Soysal, Celia Oreja-Guevara, Freek Verheul, Steve Vucic, Suzanne Hodgkinson, Mark Slee, Radek Ampapa, Julie Prevost, Jose Luis Sanchez Menoyo, Olga Skibina, Claudio Solaro, Javier Olascoaga, Cameron Shaw, Klaus Gregaard Madsen, Kerisha Naidoo, Robert Hyde, Helmut Butzkueven, Vilija Jokubaitis, on behalf of the MSBase Study Group

Research output: Contribution to journalArticleResearchpeer-review

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 - 1 Feb 2019

Keywords

  • Incidence
  • Multiple sclerosis
  • Outcomes
  • Pregnancy
  • Therapy

Cite this

Nguyen, Ai Lan ; Havrdova, Eva Kubala ; Horakova, Dana ; Izquierdo, Guillermo ; Kalincik, Tomas ; van der Walt, Anneke ; Terzi, Murat ; Alroughani, Raed ; Duquette, Pierre ; Girard, Marc ; Prat, Alexandre ; Boz, Cavit ; Sola, Patrizia ; Ferraro, Diana ; Lugaresi, Alessandra ; Lechner-Scott, Jeannette ; Barnett, Michael ; Grand'Maison, Francois ; Grammond, Pierre ; Ramo-Tello, Cristina ; Turkoglu, Recai ; McCombe, Pamela ; Pucci, Eugenio ; Trojano, Maria ; Granella, Franco ; Spitaleri, Daniele ; Van Pesch, Vincent ; Soysal, Aysun ; Oreja-Guevara, Celia ; Verheul, Freek ; Vucic, Steve ; Hodgkinson, Suzanne ; Slee, Mark ; Ampapa, Radek ; Prevost, Julie ; Menoyo, Jose Luis Sanchez ; Skibina, Olga ; Solaro, Claudio ; Olascoaga, Javier ; Shaw, Cameron ; Madsen, Klaus Gregaard ; Naidoo, Kerisha ; Hyde, Robert ; Butzkueven, Helmut ; Jokubaitis, Vilija ; on behalf of the MSBase Study Group. / Incidence of pregnancy and disease-modifying therapy exposure trends in women with multiple sclerosis : A contemporary cohort study. In: Multiple Sclerosis and Related Disorders. 2019 ; Vol. 28. pp. 235-243.
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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 = "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 and {on behalf of the MSBase Study Group}",
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Nguyen, AL, Havrdova, EK, 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, JLS, Skibina, O, Solaro, C, Olascoaga, J, Shaw, C, Madsen, KG, Naidoo, K, Hyde, R, Butzkueven, H, Jokubaitis, V & on behalf of the MSBase Study Group 2019, 'Incidence of pregnancy and disease-modifying therapy exposure trends in women with multiple sclerosis: A contemporary cohort study' Multiple Sclerosis and Related Disorders, vol. 28, pp. 235-243. https://doi.org/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. / Nguyen, Ai Lan; Havrdova, Eva Kubala; Horakova, Dana; Izquierdo, Guillermo; Kalincik, Tomas; van der Walt, Anneke; Terzi, Murat; Alroughani, Raed; Duquette, Pierre; Girard, Marc; Prat, Alexandre; Boz, Cavit; Sola, Patrizia; Ferraro, Diana; Lugaresi, Alessandra; Lechner-Scott, Jeannette; Barnett, Michael; Grand'Maison, Francois; Grammond, Pierre; Ramo-Tello, Cristina; Turkoglu, Recai; McCombe, Pamela; Pucci, Eugenio; Trojano, Maria; Granella, Franco; Spitaleri, Daniele; Van Pesch, Vincent; Soysal, Aysun; Oreja-Guevara, Celia; Verheul, Freek; Vucic, Steve; Hodgkinson, Suzanne; Slee, Mark; Ampapa, Radek; Prevost, Julie; Menoyo, Jose Luis Sanchez; Skibina, Olga; Solaro, Claudio; Olascoaga, Javier; Shaw, Cameron; Madsen, Klaus Gregaard; Naidoo, Kerisha; Hyde, Robert; Butzkueven, Helmut; Jokubaitis, Vilija; on behalf of the MSBase Study Group.

In: Multiple Sclerosis and Related Disorders, Vol. 28, 01.02.2019, p. 235-243.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

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

T2 - A contemporary cohort study

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

AU - on behalf of the MSBase Study Group

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

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JO - Multiple Sclerosis and Related Disorders

JF - Multiple Sclerosis and Related Disorders

SN - 2211-0348

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