2007-2021 年间女性使用多发性硬化症潜在致畸性疾病调整疗法的性别差异以及激素避孕的重叠程度：一项基于澳大利亚人口的研究。

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders Pub Date : 2024-10-10 DOI:10.1016/j.msard.2024.105937

A. Fragkoudi , A.R. Rumbold , K.A. Hall , J. Lechner-Scott , J. Ilomäki , L.E. Grzeskowiak

{"title":"2007-2021 年间女性使用多发性硬化症潜在致畸性疾病调整疗法的性别差异以及激素避孕的重叠程度：一项基于澳大利亚人口的研究。","authors":"A. Fragkoudi , A.R. Rumbold , K.A. Hall , J. Lechner-Scott , J. Ilomäki , L.E. Grzeskowiak","doi":"10.1016/j.msard.2024.105937","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Disease modifying treatments (DMTs) for multiple sclerosis (MS) have varying levels of teratogenic potential, but whether this influences DMT prescribing patterns by sex or concurrent use of hormonal contraception in women is unknown. This study aimed to examine patterns in dispensing of DMTs in women and men with MS, and hormonal long-acting reversible contraceptive (LARC) overlap at DMT initiation among women.</div></div><div><h3>Methods</h3><div>Population cohort study using 10% random sample of the Australian Pharmaceutical Benefits Scheme dispensing data (2007–2021). DMT dispensing data were evaluated separately for women and men aged 18–49 years. Hormonal LARC overlap was determined by receipt of contraceptive dispensing where the expected duration of efficacy overlapped with the DMT dispensing date.</div></div><div><h3>Results</h3><div>DMTs with teratogenic potential (cladribine, sphingosine-1-phosphates and teriflunomide) were less likely to be commenced in women than men aged 18–39 (OR 0.70, 0.51–0.96), but not in those aged 40–49 (OR 0.93, 0.60–1.43). Hormonal LARC overlap was higher among those commenced DMTs with teratogenic potential compared with interferons (aOR 2.52, 1.14, 5.55).</div></div><div><h3>Conclusion</h3><div>Sex and age differences in DMT utilisation were observed based on teratogenic potential. Hormonal LARC overlap appears higher in those receiving potentially teratogenic DMTs, but overall rates remain low.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"92 ","pages":"Article 105937"},"PeriodicalIF":2.9000,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Sex differences in use of potentially teratogenic disease modifying treatments for multiple sclerosis and degree of hormonal contraception overlap in women between 2007–2021: An Australian population-based study\",\"authors\":\"A. Fragkoudi , A.R. Rumbold , K.A. Hall , J. Lechner-Scott , J. Ilomäki , L.E. Grzeskowiak\",\"doi\":\"10.1016/j.msard.2024.105937\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Disease modifying treatments (DMTs) for multiple sclerosis (MS) have varying levels of teratogenic potential, but whether this influences DMT prescribing patterns by sex or concurrent use of hormonal contraception in women is unknown. This study aimed to examine patterns in dispensing of DMTs in women and men with MS, and hormonal long-acting reversible contraceptive (LARC) overlap at DMT initiation among women.</div></div><div><h3>Methods</h3><div>Population cohort study using 10% random sample of the Australian Pharmaceutical Benefits Scheme dispensing data (2007–2021). DMT dispensing data were evaluated separately for women and men aged 18–49 years. Hormonal LARC overlap was determined by receipt of contraceptive dispensing where the expected duration of efficacy overlapped with the DMT dispensing date.</div></div><div><h3>Results</h3><div>DMTs with teratogenic potential (cladribine, sphingosine-1-phosphates and teriflunomide) were less likely to be commenced in women than men aged 18–39 (OR 0.70, 0.51–0.96), but not in those aged 40–49 (OR 0.93, 0.60–1.43). Hormonal LARC overlap was higher among those commenced DMTs with teratogenic potential compared with interferons (aOR 2.52, 1.14, 5.55).</div></div><div><h3>Conclusion</h3><div>Sex and age differences in DMT utilisation were observed based on teratogenic potential. Hormonal LARC overlap appears higher in those receiving potentially teratogenic DMTs, but overall rates remain low.</div></div>\",\"PeriodicalId\":18958,\"journal\":{\"name\":\"Multiple sclerosis and related disorders\",\"volume\":\"92 \",\"pages\":\"Article 105937\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2024-10-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Multiple sclerosis and related disorders\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2211034824005133\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Multiple sclerosis and related disorders","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2211034824005133","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

摘要

背景：治疗多发性硬化症（MS）的疾病调整疗法（DMT）具有不同程度的致畸可能性，但这是否会影响DMT的性别处方模式或女性同时使用激素避孕药的情况尚不清楚。本研究旨在探讨女性和男性多发性硬化症患者的 DMTs 处方模式，以及女性在开始使用 DMT 时激素类长效可逆避孕药（LARC）的重叠情况：方法：使用澳大利亚药品福利计划配药数据（2007-2021 年）中 10% 的随机样本进行人群队列研究。分别评估了 18-49 岁女性和男性的 DMT 配药数据。荷尔蒙 LARC 重叠是通过接收避孕药具配发来确定的，其中预期疗效持续时间与 DMT 配发日期重叠：结果：18-39 岁女性开始使用具有致畸潜力的 DMT（克拉利宾、鞘氨醇-1-磷酸酯和特立氟胺）的可能性低于男性（OR 值为 0.70，0.51-0.96），但 40-49 岁女性开始使用 DMT 的可能性低于男性（OR 值为 0.93，0.60-1.43）。与干扰素相比，开始使用具有致畸潜力的 DMTs 的人群中激素 LARC 重叠率更高（aOR 2.52，1.14，5.55）：结论：根据致畸可能性观察到 DMT 使用的性别和年龄差异。在接受可能致畸的 DMTs 的人群中，激素 LARC 的重叠率似乎更高，但总体比例仍然较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Sex differences in use of potentially teratogenic disease modifying treatments for multiple sclerosis and degree of hormonal contraception overlap in women between 2007–2021: An Australian population-based study

Background

Disease modifying treatments (DMTs) for multiple sclerosis (MS) have varying levels of teratogenic potential, but whether this influences DMT prescribing patterns by sex or concurrent use of hormonal contraception in women is unknown. This study aimed to examine patterns in dispensing of DMTs in women and men with MS, and hormonal long-acting reversible contraceptive (LARC) overlap at DMT initiation among women.

Methods

Population cohort study using 10% random sample of the Australian Pharmaceutical Benefits Scheme dispensing data (2007–2021). DMT dispensing data were evaluated separately for women and men aged 18–49 years. Hormonal LARC overlap was determined by receipt of contraceptive dispensing where the expected duration of efficacy overlapped with the DMT dispensing date.

Results

DMTs with teratogenic potential (cladribine, sphingosine-1-phosphates and teriflunomide) were less likely to be commenced in women than men aged 18–39 (OR 0.70, 0.51–0.96), but not in those aged 40–49 (OR 0.93, 0.60–1.43). Hormonal LARC overlap was higher among those commenced DMTs with teratogenic potential compared with interferons (aOR 2.52, 1.14, 5.55).

Conclusion

Sex and age differences in DMT utilisation were observed based on teratogenic potential. Hormonal LARC overlap appears higher in those receiving potentially teratogenic DMTs, but overall rates remain low.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Multiple sclerosis and related disorders CLINICAL NEUROLOGY-

CiteScore

5.80

自引率

20.00%

发文量

814

审稿时长

66 days

期刊介绍： Multiple Sclerosis is an area of ever expanding research and escalating publications. Multiple Sclerosis and Related Disorders is a wide ranging international journal supported by key researchers from all neuroscience domains that focus on MS and associated disease of the central nervous system. The primary aim of this new journal is the rapid publication of high quality original research in the field. Important secondary aims will be timely updates and editorials on important scientific and clinical care advances, controversies in the field, and invited opinion articles from current thought leaders on topical issues. One section of the journal will focus on teaching, written to enhance the practice of community and academic neurologists involved in the care of MS patients. Summaries of key articles written for a lay audience will be provided as an on-line resource. A team of four chief editors is supported by leading section editors who will commission and appraise original and review articles concerning: clinical neurology, neuroimaging, neuropathology, neuroepidemiology, therapeutics, genetics / transcriptomics, experimental models, neuroimmunology, biomarkers, neuropsychology, neurorehabilitation, measurement scales, teaching, neuroethics and lay communication.