The German Multiple Sclerosis and Pregnancy Registry: rationale, objective, design, and first results

Objectives: Multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) predominantly affect women of reproductive age. During the last few decades many disease-modifying therapies (DMTs) have been approved. It is therefore important to provide epidemiological structures for the coll...

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Autores principales:	Sandra Thiel, Andrea I. Ciplea, Ralf Gold, Kerstin Hellwig
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/2e5a9530b97b474b8b53325b5eeac27f
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spelling	oai:doaj.org-article:2e5a9530b97b474b8b53325b5eeac27f2021-11-23T23:04:26ZThe German Multiple Sclerosis and Pregnancy Registry: rationale, objective, design, and first results1756-286410.1177/17562864211054956https://doaj.org/article/2e5a9530b97b474b8b53325b5eeac27f2021-11-01T00:00:00Zhttps://doi.org/10.1177/17562864211054956https://doaj.org/toc/1756-2864Objectives: Multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) predominantly affect women of reproductive age. During the last few decades many disease-modifying therapies (DMTs) have been approved. It is therefore important to provide epidemiological structures for the collection of safety information on exposed pregnancies. Data on disease activity after withdrawal of DMTs are in high demand especially as severe relapses have been described after ceasing highly effective DMTs. Although breastfeeding is recommended, it is still unclear if the early reintroduction, especially of highly effective DMTs, has a beneficial effect on postpartum relapse risk or a combination of both, however safety data are lacking. Methods: The German MS and Pregnancy Registry (DMSKW) is a nationwide, observational, cohort study of pregnant women with MS or NMOSD, founded in 2006. As the study procedure has undergone important adaptation in recent years, described here is the updated methodology including data source and acquisition as well as variables collected within the DMSKW. Results: As of December 2020, the DMSKW database comprises 2579 pregnancies, 2568 with MS and 11 with NMOSD. Women are enrolled at a median gestational week of 11 (range: 0.02–42.1), have a median postpartum follow up of 1.2 years (range: 0–9.2) with 76% of all pregnancies being exposed to a DMT, mostly in the first trimester. Spontaneous abortion and preterm birth occurred in 7% and 10%, respectively; 19% of all women suffered from at least one relapse during pregnancy, with a minimum of 6% during the third trimester of pregnancy. Conclusion: The DMSKW is a valuable structure in providing safety data on drug exposure during pregnancy and lactation in combination with information on disease activity up to 6 years postpartum. This article will be the reference for describing the methods of future publications from the DMSKW.Sandra ThielAndrea I. CipleaRalf GoldKerstin HellwigSAGE PublishingarticleNeurology. Diseases of the nervous systemRC346-429ENTherapeutic Advances in Neurological Disorders, Vol 14 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurology. Diseases of the nervous system RC346-429 Sandra Thiel Andrea I. Ciplea Ralf Gold Kerstin Hellwig The German Multiple Sclerosis and Pregnancy Registry: rationale, objective, design, and first results
description	Objectives: Multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) predominantly affect women of reproductive age. During the last few decades many disease-modifying therapies (DMTs) have been approved. It is therefore important to provide epidemiological structures for the collection of safety information on exposed pregnancies. Data on disease activity after withdrawal of DMTs are in high demand especially as severe relapses have been described after ceasing highly effective DMTs. Although breastfeeding is recommended, it is still unclear if the early reintroduction, especially of highly effective DMTs, has a beneficial effect on postpartum relapse risk or a combination of both, however safety data are lacking. Methods: The German MS and Pregnancy Registry (DMSKW) is a nationwide, observational, cohort study of pregnant women with MS or NMOSD, founded in 2006. As the study procedure has undergone important adaptation in recent years, described here is the updated methodology including data source and acquisition as well as variables collected within the DMSKW. Results: As of December 2020, the DMSKW database comprises 2579 pregnancies, 2568 with MS and 11 with NMOSD. Women are enrolled at a median gestational week of 11 (range: 0.02–42.1), have a median postpartum follow up of 1.2 years (range: 0–9.2) with 76% of all pregnancies being exposed to a DMT, mostly in the first trimester. Spontaneous abortion and preterm birth occurred in 7% and 10%, respectively; 19% of all women suffered from at least one relapse during pregnancy, with a minimum of 6% during the third trimester of pregnancy. Conclusion: The DMSKW is a valuable structure in providing safety data on drug exposure during pregnancy and lactation in combination with information on disease activity up to 6 years postpartum. This article will be the reference for describing the methods of future publications from the DMSKW.
format	article
author	Sandra Thiel Andrea I. Ciplea Ralf Gold Kerstin Hellwig
author_facet	Sandra Thiel Andrea I. Ciplea Ralf Gold Kerstin Hellwig
author_sort	Sandra Thiel
title	The German Multiple Sclerosis and Pregnancy Registry: rationale, objective, design, and first results
title_short	The German Multiple Sclerosis and Pregnancy Registry: rationale, objective, design, and first results
title_full	The German Multiple Sclerosis and Pregnancy Registry: rationale, objective, design, and first results
title_fullStr	The German Multiple Sclerosis and Pregnancy Registry: rationale, objective, design, and first results
title_full_unstemmed	The German Multiple Sclerosis and Pregnancy Registry: rationale, objective, design, and first results
title_sort	german multiple sclerosis and pregnancy registry: rationale, objective, design, and first results
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/2e5a9530b97b474b8b53325b5eeac27f
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The German Multiple Sclerosis and Pregnancy Registry: rationale, objective, design, and first results

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