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Abstract Details

Cladribine and Pregnancy in Women with Multiple Sclerosis– A Cohort Study
Multiple Sclerosis
P10 - Poster Session 10 (5:00 PM-6:00 PM)
1-007

To assess pregnancy outcomes and disease activity after cladribine(CLAD) treatment in women with multiple sclerosis (MS)

Information on pregnancy outcomes after CLAD exposure in women with MS is scarce, data to disease activity during pregnancy and postpartum is lacking

Pregnancies after CLAD treatment, documented in the German Multiple Sclerosis and Pregnancy Registry are presented.The cohort was stratified to last CLAD intake i) after last menstrual period (LMP), ii) between LMP and 6-months before LMP and iii) > 6-months before LMP. Relapse data, including EDSS-values were verified by neurologists and negative pregnancy outcomes by treating physicians

112 pregnancies in women with MS occurred after CLAD treatment, three with pregnancy exposure after LMP (median exposure duration 29 days; range 23 – 39), 24 with pregnancy exposure during the last 6-months before LMP (median days between CLAD cessation and LMP 130 days; range 2 – 180) and 84 unexposed (median days between CLAD cessation and LMP 372.5 days; range 185 – 1901). So far, three (3.4%) spontaneous abortions and two elective abortions (2.3%) occured. 21 pregnancies are ongoing, five women are lost to follow-up. Among 81 live-births with 7 (8.6%) born preterm, one (1.2%) major congenital malformation of an atrial septum defect and 10 (12.3%) minor congenital malformations were reported. Disease course was stable in most women with three (3.4%) relapses occurring in pregnancy in 86 women with completed pregnancy follow-up and four (5.1%) postpartum in 79 women with at least 3 months postpartum follow-up
The cohort showed excellent disease control during pregnancy and few relapses postpartum, without the phenomenon of rebound. Our data adds useful information on pregnancies with generally healthy newborns after CLAD treatment but is limited by the small sample size. It is important to counsel women to avoid pregnancies within 6-months after last CLAD intake and use effective contraception
Authors/Disclosures
Karen I. Dost-Kovalsky
PRESENTER 		Ms. Dost-Kovalsky has nothing to disclose.
Nadine Bast (St Josef Hospital) Mrs. Bast has received personal compensation in the range of $0-$499 for serving as a Manuscript Writer with Thieme Verlag.
Sabrina Haben (St. Josef Hospital) Sabrina Haben has nothing to disclose.
Natalia Friedmann (St. Josef Hospital) Mrs. Friedmann has nothing to disclose.
Theresa Oganowski Ms. Oganowski has nothing to disclose.
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.
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 .
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 BMS. Kerstin Hellwig has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis . Kerstin Hellwig has received personal compensation in the range of $5,000-$9,999 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 Sanofi Genzyme . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mylan . 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 $5,000-$9,999 for serving on a Speakers Bureau for Novartis . Kerstin Hellwig has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Roche . 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 BMS .