• J. Neurol. Neurosurg. Psychiatr. · Nov 2019

    Multicenter Study Observational Study

    Impact of natural menopause on multiple sclerosis: a multicentre study.

    • Damiano Baroncini, Pietro Osvaldo Annovazzi, Nicola De Rossi, Giulia Mallucci, Valentina Torri Clerici, Simone Tonietti, Vittorio Mantero, Maria Teresa Ferrò, Maria Josè Messina, Valeria Barcella, Loredana La Mantia, Marco Ronzoni, Caterina Barrilà, Raffaella Clerici, Emanuela Laura Susani, Maria Letizia Fusco, Luca Chiveri, Lucia Abate, Ottavia Ferraro, Ruggero Capra, Elena Colombo, Paolo Confalonieri, and Mauro Zaffaroni.
    • Multiple Sclerosis Centre, Gallarate Hospital, ASST Valle Olona, Gallarate, Italy damianobaroncini@gmail.com.
    • J. Neurol. Neurosurg. Psychiatr. 2019 Nov 1; 90 (11): 1201-1206.

    ObjectiveTo study the effect of natural menopause on multiple sclerosis clinical course.MethodsThis was an observational, retrospective, multicentre, cohort study. Menopause onset was defined by the final menstrual period (FMP) beyond which no menses occurred for 12 months. We included multiple sclerosis (MS) patients with FMP occurred after 2005 and a recorded follow-up of at least 2 years pre-FMP and post-FMP. We excluded patients with primary progressive course, iatrogenic menopause and with other confounders that could mask menopause onset. We compared relapse-rate and expanded disability status scale (EDSS) scores pre-FMP and post-FMP, searching for possible interactions with age, disease duration, cigarette smoking and nulliparity status.Results148 patients were included (mean observation: 3.5 years pre-FMP and post-FMP). Most patients (92%) received disease-modifying therapies, mainly first-lines. After menopause the annualised relapse rate (ARR) significantly decreased (from 0.21±0.31 to 0.13± 0.24; p=0.005), while disability worsened (increase of mean 0.4 vs 0.2 points after menopause; p<0.001). Older age and long-lasting disease were associated with ARR reduction (p=0.013), but not with disability worsening. Cigarette smokers showed a trend to a higher disability accumulation after menopause (p=0.059).ConclusionNatural menopause seems to be a turning point to a more progressive phase of MS. Relapse rate is also reduced after menopause, but this effect could be driven most by ageing and shifting to progressive phase in patients with long-lasting disease. Cigarette smoking could speed up disability progression after menopause.© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…