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Abstract Details

Postpartum Relapse Patterns Among Multiple Sclerosis Patients with Exposure to Disease Modifying Therapy Before or During Pregnancy
Multiple Sclerosis
P9 - Poster Session 9 (5:30 PM-6:30 PM)
3-002
To describe relapse patterns during pregnancy and postpartum among patients with disease modifying therapy (DMT) exposure during pregnancy in two large claims databases. 
A large proportion of women with multiple sclerosis (MS) are of childbearing age, and evolving guidance is needed regarding how to optimize management of the pregnancy and postpartum periods in light of the changing DMT landscape.
This retrospective, observational study used data from the US MarketScan Commercial and Medicaid claims databases. Female patients analyzed had ≥1 insurance claim submitted under the diagnosis code of MS from 01/01/2016-04/30/2021 and continuous enrollment eligibility from ≥6 month prior to pregnancy date (pre-pregnancy) through 6 months of follow-up following delivery (postpartum period). Moderate/severe relapse was defined as MS-related hospitalization or an outpatient visit and 1 claim within 7 days of the visit with steroids or total plasma exchange. 
A total of 944 patients (mean [SD] age, 32.4 [5.0] years) were eligible (commercial, n=688; Medicaid n=256). Overall, the proportion of patients with any moderate/severe relapse declined over pregnancy (from pre-pregnancy, n=82 [8.7%]; trimester [T] 1, n=11 [1.2%]; T2, n=8 [0.9%]; T3, n=10 [1.1%]) but increased postpartum. More relapses were experienced 0-3 months postpartum (n=61 [6.5%]) compared to 4-6 months postpartum (n=51 [5.4%]). Of the 889 patients who stopped DMT for pregnancy, the risk of postpartum relapses was lower in the women who resumed DMT postpartum (10/192) than in patients who did not, (76/697) (5.2% vs. 10.9%, p=0.018). 

The proportion of patients with MS experiencing a moderate/severe relapse and number of relapses declined over pregnancy but increased postpartum. Reinitiation of DMT during the postpartum period was associated with lower risk of relapses. Current findings support a role for early reinitiation of DMT postpartum.
Authors/Disclosures
Riley Bove, MD, FAAN (University of California, San Francisco)
PRESENTER 		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.
Angela Applebee, MD (St Peter'S MS Center) Dr. Applebee has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Applebee has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech. Dr. Applebee has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genzyme. Dr. Applebee has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Serono. Dr. Applebee has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Horizon. Dr. Applebee has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb.
Katrina Bawden, NP (Rocky Mountain MS Clinic) Ms. Bawden has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. Ms. Bawden has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biohaven. Ms. Bawden has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Banner Life Sciences. Ms. Bawden has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for TG therapeutics.
Celeste Fine (Gilbert Neurology) Ms. Fine has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Ms. Fine has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie.
Anna Shah, MD (University of Colorado, Neurology Dept) The institution of Dr. Shah has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. The institution of Dr. Shah has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. The institution of Dr. Shah has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. The institution of Dr. Shah has received research support from Rocky Mountain MS Center. The institution of Dr. Shah has received research support from Genentech/Roche. Dr. Shah has received personal compensation in the range of $500-$4,999 for serving as a 好色先生al Speaker with Rocky Mountain MS Center.
Robin L. Avila, PhD (Biogen) Mrs. Avila has received personal compensation for serving as an employee of Biogen. Mrs. Avila has stock in Biogen.
Nicholas Belviso, PhD, PharmD Dr. Belviso has received personal compensation for serving as an employee of Biogen.
No disclosure on file
Kinyee Fong (Biogen) Dr. Fong has received personal compensation for serving as an employee of Biogen. Dr. Fong has stock in Biogen.
James B. Lewin, PharmD Dr. Lewin has received personal compensation for serving as an employee of Biogen. Dr. Lewin has stock in Biogen.
No disclosure on file
Sarah England, PhD (Biogen) Dr. England has received personal compensation for serving as an employee of Biogen. Dr. England has stock in Biogen.
Megan Vignos, PhD (Biogen) Dr. Vignos has stock in Biogen. Dr. Vignos has received personal compensation in the range of $100,000-$499,999 for serving as a Employee with Biogen.