文摘
摘要目的:评估疾病修饰治疗(DMT)利用治疗多发性硬化症(MS)之前,期间和之后怀孕。
背景:怀孕是一种常见的考虑女性的女士;岁的女士发病通常20-45年,即在生育年龄。怀孕和产后护理是一个重要的因素影响DMT选择对许多患者女士到目前为止,很少有儿童安全继续怀孕期间和真实的治疗模式之前,期间和之后怀孕仍无特征。
设计/方法:本回顾性观察研究,美国MarketScan商业和医疗补助声称数据库评估18-55岁女性患者,诊断和≥1 delivery-related女士住院或门诊声称从2016年1月1日- 2021年4月30日。
结果:一群944名患者被确认;commercially-insured 688(73%)和256年(27%)获得医疗补助。怀孕期间DMT使用率大幅下降,从36.3%的患者在怀孕前6个月(怀孕前)为17.9%,5.3%和5.8%的三学期制(T) 1、2和3,分别。产后DMT利用率提高到20.9%,0 - 3个月,4 - 6个月时的24.4%。所有的病人(n = 944)的怀孕前时期,最常用的儿童是glatiramer醋酸(15.0%)、富马酸二甲酯(6.4%)、干扰素(5.4%)和natalizumab (5.2%)。任何DMT T1,患者的患者更有可能继续治疗到T3如果接受natalizumab和glatiramer醋酸(60.9% (T1)到10.9% (T3)和54.8% (T1)到20.7% (T3),分别)与干扰素(36.7% (T1)到8.2% (T3)), fingolimod (35.1% (T1)到8.1% (T3)),富马酸二甲酯(28.1% (T1)到7.0% (T3)),或ocrelizumab (6.7% (T1)到0% (T3))。
结论:怀孕期间DMT利用率大幅下降;逐渐增加产后但仍低于怀孕前使用。每6 - 12个月不熔化的管理(例如,anti-CD20药物)可能被低估了。
披露:Shah博士的机构已收到个人薪酬在500 - 4999美元的范围为在科学咨询服务或数据安全监测委员会基因泰克。沙阿博士的机构已收到个人薪酬在500 - 4999美元的范围为在科学咨询服务或数据安全监测委员会TG疗法。沙阿博士获得了个人薪酬在5000 - 9999美元的范围作为教育议长女士与落基山中心。Bove博士已经收到个人薪酬在5000 - 9999美元的范围作为顾问生原体。Bove博士已经收到个人薪酬在500 - 4999美元的范围为在科学咨询服务或数据安全监测委员会。Bove博士已经收到个人薪酬在5000 - 9999美元的范围为在科学咨询服务或数据安全监测委员会生原体。Bove博士已经收到个人薪酬在5000 - 9999美元的范围为在科学咨询服务或数据安全监测委员会EMD Serono。Bove博士已经收到个人薪酬在10000 - 49999美元的范围为在科学咨询服务或数据安全监测委员会Genzyme赛诺菲。Bove博士已经收到个人薪酬在10000 - 49999美元的范围为在科学咨询服务或数据安全监测委员会诺华。Bove博士已经收到个人薪酬在10000 - 49999美元的范围为在科学咨询服务或数据安全监测委员会TG疗法。 Dr. Bove has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jansen. Dr. Bove has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. The institution of Dr. Bove has received research support from Biogen. The institution of Dr. Bove has received research support from Roche Genentech. The institution of Dr. Bove has received research support from Novartis. Dr. Applebee has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Applebee has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech. Dr. Applebee has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genzyme. Dr. Applebee has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Serono. Dr. Applebee has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Horizon. Dr. Applebee has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb. Ms. Bawden has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. Ms. Bawden has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biohaven. Ms. Bawden has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Banner Life Sciences. Ms. Bawden has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for TG therapeutics. Ms. Fine has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Ms. Fine has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie. Mrs. Avila has received personal compensation for serving as an employee of Biogen. Mrs. Avila has stock in Biogen. Dr. Belviso has received personal compensation for serving as an employee of Biogen. Filipe Branco has received personal compensation for serving as an employee of Biogen. Filipe Branco has received stock or an ownership interest from Biogen. Dr. Fong has received personal compensation for serving as an employee of Biogen. Dr. Lewin has received personal compensation for serving as an employee of Biogen. Dr. Lewin has stock in Biogen. Ms. LIU has received personal compensation for serving as an employee of Biogen . Ms. LIU has stock in Biogen. Dr. England has received personal compensation for serving as an employee of Biogen. Dr. England has stock in Biogen. Dr. Vignos has stock in Biogen. Dr. Vignos has received personal compensation in the range of $100,000-$499,999 for serving as a Employee with Biogen.
