Conference Coverage
NEW ORLEANS – The proportion of women with multiple sclerosis with a live birth receiving disease-modifying drug therapy was low and declined during the prepregnancy and pregnancy periods, results from a large analysis of national claims data found.
“Multiple sclerosis is up to three times more common in women than in men, and the clinical onset is often during childbearing years,” researchers led by Maria K. Houtchens, MD, wrote in an abstract presented during the annual meeting of the Consortium of Multiple Sclerosis Centers. “A better understanding of the ‘real world’ disease-modifying drug treatment patterns in women with MS and a pregnancy is essential in order to improve available clinical support, health care services, and quality of life for women with MS of childbearing age.”
Dr. Maria Houtchens
Dr. Houtchens, a neurologist at Brigham and Women’s Hospital, Boston, and her associates reported results from 2,518 women who were included in the final analysis. Their mean age was 30 years, and 99% had commercial health insurance.
Overall, the proportion of women with MS and a live birth receiving DMD treatment was low, ranging from 1.9% to 25.5%, and the rate of treatment declined during the prepregnancy and pregnancy periods.
During pregnancy, the proportion of women treated with a DMD decreased to 12.05% during the first trimester and to 1.90% during the second trimester, and then increased to 2.97% during the third trimester. At 9-12 months postpartum, the proportion of women treated with a DMD was 25.5%. Most patients were treated with self-injectable DMDs (from 1.7% to 19.6%), while the use of oral and infusion agents was low (0.1%-3.1% and 0%-0.2%, respectively).
The researchers also found that the proportion of women with DMD treatment before and after pregnancy increased significantly with the number of relapses experienced prepregnancy. A greater number of relapses before pregnancy led to more patients treated with DMDs.
They acknowledged certain limitations of the study, including its reliance on information from patients with health insurance administered by regional health plans. “Results may not be generalizable to patients who self-pay or patients without employer-sponsored commercial health insurance.”
The study was supported by EMD Serono. Dr. Houtchens reported that she has received funding support from EMD Serono and that she serves on the scientific advisory boards for Biogen, Novartis, Sanofi Genzyme, and Teva Neuroscience. She also has received research support from Sanofi Genzyme.