Abstract Details

Title The Impact of Disease-modifying Therapy on Relapse Risk in Women with Multiple Sclerosis Undergoing Assisted Reproductive Technologies (ART)

Topic Multiple Sclerosis

Presentation(s) S7 - Multiple Sclerosis: Special Populations and Non-MS CNS Neuroinflammatory Disease (4:18 PM-4:30 PM)

Poster/Presentation
Number 005

Background Previous research reported an increased relapse risk after ART, newer studies lead to different conclusions. This study builds upon investigations by extending the cohort and focusing on the role of DMT in mitigating post-ART relapse risk.

Objective To investigate the influence of ART on the relapse risk in women with multiple sclerosis (MS). To assess benefits of maintaining disease-modifying therapy (DMT) during ART.

Design/Methods Recruitment of women in an ART and MS sub-registry of the German Multiple Sclerosis and Pregnancy Registry (DMSKW) both prospectively and retrospectively. Telephone interviews with a standardized questionnaire gathered information on stimulations, pregnancy, disease course during and after ART. Poisson regression analyzed annualized relapse rates and relapse rate ratios, comparing the risk period three months post-ART versus the no risk period twelve months prior to ART or between stimulations.

Results

126 women accounting for 344 stimulations with 229 (6.57%) under DMT (72.93% on first-line, 27.07% on second-line treatments). Relapses occured after 20/344 (5.81%) stimulations, fewer (7 (35%)) under DMTs versus 13 (65%) without DMT (p=0.005). Relapse rate ratios (RRR) were statistically significantly lower with the use of any DMT (RRR 0.18 [95% CI 0.08;0.42]), either first-line (0.51 [0.32;0.8] or second-line (0.15 [0.05;0.44]) during ART. Age, BMI, disease course, disease duration, stimulation protocol and ART outcome were not associated with the occurrence of relapses after ART. Of note pregnancy was not assicated with a reduced relapse risk ( 0.91 [0.47;1.77]).

Conclusions

Relapse risk after ART was low and ART not associated with an increased relapse risk in this contemporary cohort. Maintaining DMTs (first and second-lines) during ART was the only modifiable factor associated with a reduction in relapse risk. The results are reassuring for women with MS who plan ART and are emphasizing the need for close disease management and counseling with pregnancy safe DMTS throughout the reproductive journey.

Authors/Disclosures
Nele R. Range PRESENTER	Miss Range has nothing to disclose.
Sabrina Haben	No disclosure on file
Sandra Thiel (Department of Neurology, St. Josef Hospital, Ruhr University, Bochum, Germany)	Ms. Thiel has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer Healthcare .
Ralf Gold, MD (Neurologische Universitaetsklinik)	Dr. Gold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen . Dr. Gold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Gold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer Vital. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai Pharamaceuticals. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Gold has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for SAGE Publishers. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Novartis. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Biogen. The institution of Dr. Gold has received research support from Novartis. The institution of Dr. Gold has received research support from Biogen.
Kerstin Hellwig (St. Josef Hospital Bochum)	Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for INC research . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche . Kerstin Hellwig has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Merck . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer . The institution of Kerstin Hellwig has received research support from Roche . The institution of Kerstin Hellwig has received research support from Merck . The institution of Kerstin Hellwig has received research support from Biogen. The institution of Kerstin Hellwig has received research support from Genzyme . The institution of Kerstin Hellwig has received research support from Novartis . The institution of Kerstin Hellwig has received research support from TEVA.