Abstract Details

Title Comparison Of Continuous vs. Cyclic Oral Contraceptives in Women with Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-099

Objective To compare rates of multiple sclerosis (MS) inflammatory activity in women on continuous vs. cyclic oral contraceptives (OCs).

Background Many women with MS report fluctuating symptoms across their menstrual cycle. It is not clear whether these fluctuations correlate with pathophysiological mechanisms, such as MS inflammatory activity. Oral contraceptives (OCs) can be administered in "continuous" (steady hormones doses over up to 3 months, followed by a week of placebo) or "cyclic" (hormones for just 21 days, then a week of placebo) fashion. We hypothesized that due to reduced hormonal fluctuations, women with MS might experience less inflammatory activity on continuous OCs than on cyclic OCs.

Design/Methods For women with MS aged 18-50 seen at the UCSF MS Center, we extracted data on OC use from the Electronic Medical Records (EMR) system. Clinical chart review was performed to verify clinical information. We identified 17 women with relapsing forms of MS on continuous OCs and matched them (2:1 when possible) to women on cyclic OCs for OC formulation, age, and MS duration. The two groups were then compared using log-rank tests (time to new relapse and new T2 lesion formation) and t-tests (annualized relapse rate) performed in R.

Results The 17 patients on continuous OCs were matched with the 27 women on cyclic OCs for age, MS type and MS duration (p>0.10 for each), as well as for OC formulation. There was no difference in annualized relapse rate (p=0.81), time to new relapse (p=0.88), or new T2-weighted lesion formation (enhancing and non-enhancing; p=0.10) during the observation period between the continuous and cyclic OC groups.

Conclusions

Based on the results from this small study, we estimate that 114 patients would be required for an adequately powered observational study to determine whether continuous OCs are associated with less inflammatory activity than cyclic OCs in women with MS.

Authors/Disclosures
Chelsea S. Chen PRESENTER	Ms. Chen has nothing to disclose.
	No disclosure on file
	No disclosure on file
Annika Anderson	No disclosure on file
Lynn Do, PharmD (Eli Lilly)	Dr. Do has received personal compensation for serving as an employee of Eli Lilly.
Riley Bove, MD, FAAN (University of California, San Francisco)	Dr. Bove has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion. Dr. Bove has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amgen. Dr. Bove has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genzyme-Sanofi. Dr. Bove has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for TG Therapeutics. Dr. Bove has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD-Serono. Dr. Bove has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cadenza. The institution of Dr. Bove has received research support from Biogen. The institution of Dr. Bove has received research support from Eli Lilly. The institution of Dr. Bove has received research support from Novartis. The institution of Dr. Bove has received research support from Roche Genentech.

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