Session: FP19-Female Reproductive Endocrinology
Room 102 (Moscone Center)
Poster Board SUN-498
Aim. A retrospective cross-sectional study designed to assess the long-term effects of combined OC (COC) on the clinical course of relapsing-remitting onset MS (RR-MS), especially on disability progression and evolution in secondary progressive MS (SP-MS).
Design & Methods. 174 women with clinically and MRI-confirmed RR-MS lasting more than one year were recruited. The following data were collected: clinical neurological data, age at onset of MS, disease duration, annualized relapse rate, disease-modifying therapies (DMT), evaluation of disability with Expanded Disability Status Scale (EDSS) and evolution in SP-MS, gynecological and obstetric history including age, duration and type of OC intake.
Results. Length of follow up of MS was 14 ± 10 years. COC-users (n=111) had lower EDSS scores (p=0.004) and reduced tendency to evolve to SP-MS (p=0.008) compared to non-users (n=63). After correction for confounding variables, such as duration of disease, DMT, age of menarche and parity, the use of COC remained associated with lower EDSS scores (p=0.011 with eta-squared 0.038). Using multivariate survival analysis with Cox's regression model, non-use of COC was a predictor of evolution in SP-MS (p=0.001 and OR=3.499 95% CI=1.673–7.321). Use of COC after the onset of MS (n=78) was associated with significantly lower EDSS scores (p=0.005) and with a reduced tendency of progression to SP-MS (p=0.001). The annualized relapse rate was not influenced by COC use. No differences in EDSS scores and evolution to SP-MS depending upon COC formulation were detected.
Conclusions. Our results suggest that COC use in RR-MS women is associated with a less severe disease and less severe evolution. Whether different doses or types of progestin may have different effects remain to be defined.
Nothing to Disclose: GG, FS, IB, MB, IM, ML, SV, CMM
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