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Abstract Details

Postpartum Clinical and Radiographic Activity in Patients with Multiple Sclerosis Stratified by Prepartum DMT Use
Multiple Sclerosis
P10 - Poster Session 10 (5:00 PM-6:00 PM)
1-012

To assess frequency of clinical and radiographic postpartum relapses in women with multiple sclerosis (MS) stratified by prepartum disease modifying therapy (DMT) use
MS disproportionately affects women of childbearing age. Prior studies have demonstrated that relapse rates in women with MS decreases during pregnancy but increases substantially in the first several months postpartum. The effect of highly effective DMT on postpartum relapse rates, including radiographic changes, has not been well established
A retrospective chart review of women who had successfully completed one pregnancy at the University of Colorado from 2013-2023 was done. Inclusion criteria included the use of a DMT prepartum and follow up for at least one year after delivery. Those with incomplete data were not included.
A total of 194 patients and 252 pregnancies were identified. The cohort was primarily Caucasian (n=192, 76%) and non-Hispanic (n=219, 87%). The average age at conception was 31.8 years (SD 4.9) with average duration of MS diagnosis at conception of 6.2 years (SD 4.4). The majority were on an anti-CD20 therapy prepartum (n=122, 48%), followed by glatiramer acetate (n=58, 23%) and natalizumab (n=35, 14%). There was a statistically significant difference in postpartum vs preconception relapse rate ratio noted only in the anti-cd20 group (rate ratio 0.37, p=-0.028). 219 pregnancies had postpartum MRI scans that had a prepartum MRI comparison. In those on anti-CD20 therapies, 8/109 (7%) had new postpartum lesions compared to 15/30 (50%) postpartum MRI scans in natalizumab treated patients with an anti-CD20 vs natalizumab risk ratio estimate of 0.15 (p=0.0002[EA1] ).  
Our data demonstrate a lower postpartum relapse and new MRI lesion rate compared to prepartum rates on anti-CD20 therapies, a stark contrast to existing published data. This may indicate a new treatment paradigm for people living with MS of childbearing age that desire pregnancy.
Authors/Disclosures
Enrique Alvarez, MD, PhD (University of Colorado)
PRESENTER 		Dr. Alvarez has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Alvarez has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Alvarez has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Alvarez has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Alvarez has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Alvarez has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Alvarez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Alvarez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celgene/BMS. The institution of an immediate family member of Dr. Alvarez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. The institution of Dr. Alvarez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon.
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.