Abstract Details

Title Relapse Risk During the Pregnancy and Postpartum Periods in Patients With Preexisting MOG Antibody Associated Disorder: A Two-Center Retrospective Study

Topic Autoimmune Neurology

Presentation(s) S38 - NMOSD, MOGAD, Demyelinating, and Other (2:48 PM-3:00 PM)

Poster/Presentation
Number 010

Objective

To calculate the rate of relapse during pregnancy and 12-month postpartum periods in women with preexisting diagnosis of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD).

Background Risk of relapse is increased during the postpartum period in untreated multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). Less is known about the risk of relapse during pregnancy and the postpartum period in women with preexisting MOGAD.

Design/Methods

Two large MOGAD clinics at NYU Multiple Sclerosis Care Center, New York, and The Neuroimmunology Clinic at Massachusetts General Hospital, Boston, conducted retrospective chart reviews on all cases of neuroimmunologist-diagnosed MOGAD and identified all pregnancies that occurred after MOGAD onset. Relevant demographic, neurologic, and obstetrical data were extracted from the charts, with special attention to pregnancy/postpartum periods.

Results Sixteen women with MOGAD experienced a total of 22 pregnancies after disease onset. Mean age at first post-MOGAD onset pregnancy was 30.9 ± 4.1 years, and mean disease duration at first pregnancy was 8.37 ± 5.7 years. None of the patients (0%) experienced a neurologist-confirmed relapse during pregnancy. One patient (6.3%) experienced two relapses of optic neuritis 3 weeks and 7 months postpartum while on low-dose prednisone. For 13/22 pregnancies, patients were on a disease modifying therapy (DMT) at the time of conception and 7/22 continued DMT throughout pregnancy. In 8/22 pregnancies, a DMT was started during the postpartum period; 6 of which were started within 2 months after giving birth. Sixteen of 22 pregnancies were carried to term, 2 of 22 are ongoing. Three pregnancies not carried to term were a result of termination, ectopic pregnancy, and miscarriage. Complications during pregnancy or delivery were recorded for 9/22 pregnancies.

Conclusions Preliminary data suggests that relapse during pregnancy/postpartum is rare in women with MOGAD. However, many patients were on a DMT during pregnancy/postpartum, which may have lowered the relapse risk.

Authors/Disclosures
Angie H. Kim PRESENTER	Ms. Kim has nothing to disclose.
Olivia R. Pasquale	Ms. Pasquale has nothing to disclose.
Gabriela Romanow (Massachusetts General Hospital)	Gabriela Romanow has nothing to disclose.
Heather Tchen, Student	Miss Tchen has nothing to disclose.
Michael Levy, MD, PhD, FAAN (Massachusetts General Hospital/Harvard Medical School)	Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi Pharma. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB Pharma. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Levy has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various law firms. The institution of Dr. Levy has received research support from National Institutes Health.
Ilya Kister, MD, FAAN (NYU School of Medicine)	Dr. Kister has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech-Roche. Dr. Kister has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. The institution of Dr. Kister has received research support from Genentech. The institution of Dr. Kister has received research support from Novartis. Dr. Kister has received publishing royalties from a publication relating to health care.

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