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Multiple sclerosis

RESEARCH PAPER

Postpartum relapses increase the risk of disability progression in multiple sclerosis: the role of disease modifying drugs Emilio Portaccio,1 Angelo Ghezzi,2 Bahia Hakiki,1 Andrea Sturchio,1 Vittorio Martinelli,3 Lucia Moiola,3 Francesco Patti,4 Gian Luigi Mancardi,5 Claudio Solaro,6 Maria Rosaria Tola,7 Carlo Pozzilli,8 Laura De Giglio,8 Rocco Totaro,9 Alessandra Lugaresi,10 Giovanna De Luca,10 Damiano Paolicelli,11 Maria Giovanna Marrosu,12 Giancarlo Comi,3 Maria Trojano,11 Maria Pia Amato,1 for the MS Study Group of the Italian Neurological Society ▸ Additional material is published online only. To view please visit the journal online (http://dx.doi.org/10.1136/ jnnp-2013-306054). For numbered affiliations see end of article. Correspondence to Dr Emilio Portaccio, Department of NEUROFARBA, University of Florence, Viale Morgagni 85, Florence 50134, Italy; [email protected] Received 10 June 2013 Revised 27 November 2013 Accepted 8 December 2013 Published Online First 8 January 2014

ABSTRACT Objective To assess relapses, disability progression and the role of disease modifying drugs (DMDs) in the year after delivery in women with multiple sclerosis (MS). Methods We prospectively followed-up pregnancies occurring between 2002 and 2008 in women with MS, recruited from 21 Italian MS centres. The risk of relapses and disability progression in the year after delivery was assessed using time-dependent Cox regression analysis. Results 350 out of 423 pregnancies were assessed ( pregnancies not resulting in live birth and with a postpartum follow-up period shorter than 1 year were excluded from the analysis). 148 patients (42.3%) had at least one relapse in the year after delivery. An Expanded Disability Status Scale (EDSS) score at conception ≥2.0 (HR=1.4; 95% CI 1.1 to 2.0; p=0.046) and a higher number of relapses before (HR=1.5; 95% CI 1.2 to 1.8; p

Postpartum relapses increase the risk of disability progression in multiple sclerosis: the role of disease modifying drugs.

To assess relapses, disability progression and the role of disease modifying drugs (DMDs) in the year after delivery in women with multiple sclerosis ...
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