Maintenance of Immunomodulatory Treatment During ART Reduces Relapse Risk in MS

Women with multiple sclerosis (MS) receiving disease-modifying immunomodulators during treatment with assisted reproductive technologies (ART) may have reduced relapse risk, according to study results presented at the 2023 American Academy of Neurology (AAN) Annual Meeting, held from April 22 to 27, in Boston, Massachusetts.

Previous research has shown that risk for relapse may be increased among patients with MS receiving treatment with ART.

For the study, researchers enrolled women with MS from a sub registry of the German Multiple Sclerosis and Pregnancy Registry to assess the effect of ART on relapse risk in this population.

Data on stimulation protocols, pregnancy, and disease course were prospectively and retrospectively collected from participants through a questionnaire.

A total of 91 women (mean age, 34.15±3.75 years; median disease duration, 4.3 years) were included in the analysis, of whom 83 (93.41%) had relapsing remitting MS, 6 (4.4%) had clinically isolated syndrome, and 2 (2.2%) had radiologic isolated syndrome.

Overall, 270 stimulations were reported, with 49 (n=18) reported prospectively and 221 (n=81) reported retrospectively. The majority of ART stimulations (186; 68.90%) were performed with the continuation of disease-modifying treatment (DMT).

The researchers observed that MS relapses occurred after 3 months in 25 (9.26%) stimulations. 

A total of 92 (34.07%) of the stimulations resulted in pregnancy; however, no significant differences in relapses were noted among women who did and did not get pregnant (P =.6519).

Compared with participants who did not receive DMT during ART, those who did receive the treatment had fewer relapses per stimulation (5.91% vs 16.67%, respectively; P =.009)

Overall, the maintenance of DMT during ART was associated with a reduction in relapse risk among patients with MS.

The researchers concluded, “MS disease activity should be controlled and pregnancy compatible DMT during ART continued.”