Is pregnancy in MS patients safe and what is its impact on MS
course? Real World evidence of 1533 pregnancies in Czech
Republic

J 2022

Is pregnancy in MS patients safe and what is its impact on MS course? Real World evidence of 1533 pregnancies in Czech Republic

HRADILEK, Pavel, Eva MELUZINOVA, Olga ZAPLETALOVA, Petra HANULIKOVA, Dana HORAKOVA et. al.

Basic information

Original name

Is pregnancy in MS patients safe and what is its impact on MS course? Real World evidence of 1533 pregnancies in Czech Republic

Authors

HRADILEK, Pavel (203 Czech Republic, guarantor), Eva MELUZINOVA (203 Czech Republic), Olga ZAPLETALOVA (203 Czech Republic), Petra HANULIKOVA (203 Czech Republic), Dana HORAKOVA (203 Czech Republic), Ivana WOZNICOVA (203 Czech Republic), Lubomir PAVLISKA (203 Czech Republic), Ivana STETKAROVA (203 Czech Republic), Martin VALIS (203 Czech Republic), Pavel ŠTOURAČ (203 Czech Republic, belonging to the institution), Jana ADAMKOVA (203 Czech Republic), Radek AMPAPA (203 Czech Republic), Marta VACHOVA (203 Czech Republic) and Jan MARES (203 Czech Republic)

Edition

MULTIPLE SCLEROSIS AND RELATED DISORDERS, OXFORD, ELSEVIER SCI LTD, 2022, 2211-0348

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30210 Clinical neurology

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 4.000

RIV identification code

RIV/00216224:14110/22:00128222

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.msard.2021.103391

UT WoS

000791995000014

Keywords in English

Multiple sclerosis; Pregnancy; EDSS; Relapses; Czech national registry ReMuS

Abstract

V originále

Background: A special care of MS women planning a pregnancy is highly demanding especially in the terms of disease modifying treatment (DMD) decisions and counselling regarding periods of conception, pregnancy and postpartum period.Objective: To provide data about impact of pregnancy, delivery or miscarriage/artificial abortion on MS disease course in Czech women with MS based on analysis of retrospective data from the Czech national registry ReMuS.Methods: The analysis focused on women with MS with at least one record of pregnancy in the registry. Clinical data (EDSS, relapses) were collected prior to conception, during pregnancy and after delivery or miscarriage/ artificial abortion. These data were analysed according to baseline characteristics of DMD treatment prior to conception and according to breastfeeding status.Results: A total of 1 533 pregnancies were analysed from the period of 2013 until 31st December 2019. The occurrence of relapses and worse EDSS was significantly related to the treatment with escalation therapy prior to conception. Relapses were significantly more frequent in women who breastfed less than 3 months than in women who breastfed more than 3 months or did not breastfeed at all. Patients treated with either fingolimod or natalizumab prior to pregnancy were significantly more likely to develop relapses during pregnancy.Conclusion: Pregnancy and postpartum period were generally safe for Czech women with MS. Better disease outcomes were observed in those who had been treated with first line injectable DMDs prior to conception and those who either breastfed more than 3 months or did not breastfeed at all. We confirmed the assumption of rebound phenomenon of MS after discontinuation of treatment due to planned pregnancy both for fingolimod and natalizumab.

Citovat

HRADILEK, Pavel, Eva MELUZINOVA, Olga ZAPLETALOVA, Petra HANULIKOVA, Dana HORAKOVA, Ivana WOZNICOVA, Lubomir PAVLISKA, Ivana STETKAROVA, Martin VALIS, Pavel ŠTOURAČ, Jana ADAMKOVA, Radek AMPAPA, Marta VACHOVA and Jan MARES. Is pregnancy in MS patients safe and what is its impact on MS course? Real World evidence of 1533 pregnancies in Czech Republic. MULTIPLE SCLEROSIS AND RELATED DISORDERS. OXFORD: ELSEVIER SCI LTD, 2022, vol. 59, March 2022, p. 1-7. ISSN 2211-0348. Available from: https://dx.doi.org/10.1016/j.msard.2021.103391.

@article{2249110,
   author = {Hradilek, Pavel and Meluzinova, Eva and Zapletalova, Olga and Hanulikova, Petra and Horakova, Dana and Woznicova, Ivana and Pavliska, Lubomir and Stetkarova, Ivana and Valis, Martin and Štourač, Pavel and Adamkova, Jana and Ampapa, Radek and Vachova, Marta and Mares, Jan},
   article_location = {OXFORD},
   article_number = {March 2022},
   doi = {http://dx.doi.org/10.1016/j.msard.2021.103391},
   keywords = {Multiple sclerosis; Pregnancy; EDSS; Relapses; Czech national registry ReMuS},
   language = {eng},
   issn = {2211-0348},
   journal = {MULTIPLE SCLEROSIS AND RELATED DISORDERS},
   title = {Is pregnancy in MS patients safe and what is its impact on MS course? Real World evidence of 1533 pregnancies in Czech Republic},
   url = {https://www.sciencedirect.com/science/article/pii/S2211034821006581?via%3Dihub},
   volume = {59},
   year = {2022}
}

TY  - JOUR
ID  - 2249110
AU  - Hradilek, Pavel - Meluzinova, Eva - Zapletalova, Olga - Hanulikova, Petra - Horakova, Dana - Woznicova, Ivana - Pavliska, Lubomir - Stetkarova, Ivana - Valis, Martin - Štourač, Pavel - Adamkova, Jana - Ampapa, Radek - Vachova, Marta - Mares, Jan
PY  - 2022
TI  - Is pregnancy in MS patients safe and what is its impact on MS course? Real World evidence of 1533 pregnancies in Czech Republic
JF  - MULTIPLE SCLEROSIS AND RELATED DISORDERS
VL  - 59
IS  - March 2022
SP  - 1-7
EP  - 1-7
PB  - ELSEVIER SCI LTD
SN  - 22110348
KW  - Multiple sclerosis
KW  - Pregnancy
KW  - EDSS
KW  - Relapses
KW  - Czech national registry ReMuS
UR  - https://www.sciencedirect.com/science/article/pii/S2211034821006581?via%3Dihub
N2  - Background: A special care of MS women planning a pregnancy is highly demanding especially in the terms of disease modifying treatment (DMD) decisions and counselling regarding periods of conception, pregnancy and postpartum period.Objective: To provide data about impact of pregnancy, delivery or miscarriage/artificial abortion on MS disease course in Czech women with MS based on analysis of retrospective data from the Czech national registry ReMuS.Methods: The analysis focused on women with MS with at least one record of pregnancy in the registry. Clinical data (EDSS, relapses) were collected prior to conception, during pregnancy and after delivery or miscarriage/ artificial abortion. These data were analysed according to baseline characteristics of DMD treatment prior to conception and according to breastfeeding status.Results: A total of 1 533 pregnancies were analysed from the period of 2013 until 31st December 2019. The occurrence of relapses and worse EDSS was significantly related to the treatment with escalation therapy prior to conception. Relapses were significantly more frequent in women who breastfed less than 3 months than in women who breastfed more than 3 months or did not breastfeed at all. Patients treated with either fingolimod or natalizumab prior to pregnancy were significantly more likely to develop relapses during pregnancy.Conclusion: Pregnancy and postpartum period were generally safe for Czech women with MS. Better disease outcomes were observed in those who had been treated with first line injectable DMDs prior to conception and those who either breastfed more than 3 months or did not breastfeed at all. We confirmed the assumption of rebound phenomenon of MS after discontinuation of treatment due to planned pregnancy both for fingolimod and natalizumab.
ER  -

HRADILEK, Pavel, Eva MELUZINOVA, Olga ZAPLETALOVA, Petra HANULIKOVA, Dana HORAKOVA, Ivana WOZNICOVA, Lubomir PAVLISKA, Ivana STETKAROVA, Martin VALIS, Pavel ŠTOURAČ, Jana ADAMKOVA, Radek AMPAPA, Marta VACHOVA and Jan MARES. Is pregnancy in MS patients safe and what is its impact on MS course? Real World evidence of 1533 pregnancies in Czech Republic. \textit{MULTIPLE SCLEROSIS AND RELATED DISORDERS}. OXFORD: ELSEVIER SCI LTD, 2022, vol.~59, March 2022, p.~1-7. ISSN~2211-0348. Available from: https://dx.doi.org/10.1016/j.msard.2021.103391.

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