Hormonal Contraceptives and Multiple Sclerosis Susceptibility (S34.003)

Abstract

OBJECTIVE: To determine whether contemporary hormonal contraceptives (HC) use increases the risk of MS BACKGROUND: Whether use of contemporary HCs contributes to the rising incidence of multiple sclerosis (MS) in women is unclear. DESIGN/METHODS: We conducted a population-based nested case-control study from the membership of Kaiser Permanente Southern California (KPSC). We identified females ages 14-48 years with incident MS or it’s precursor-clinically isolated syndrome (CIS) between 2008 and 2011, who had at least 3 years of continuous membership prior to symptom onset. Ten controls per case were matched on age, race/ethnicity and membership characteristics. Data were obtained from the complete electronic health record and analyzed using conditional logistic regression, adjusted for smoking and live births 3 yrs prior to symptom onset. RESULTS: We identified 305 incident female cases with MS/CIS and 3050 matched-controls. 29.2% of cases and 23.5% of controls had used a HC for at least 3 months within the 3 years prior to symptom onset. The majority used estrogen/progestin combination preparations. Women that used any hormonal contraceptive in the 3 years prior to symptoms onset, and particularly those that had stopped at least 1 month prior to symptom onset, had a slightly increased risk of MS/CIS (ever-users adjusted OR=1.35, 95%CI=1.01-1.80, p=0.04; not current users adjusted OR=1.50, 95%CI=1.05-2.14, p=0.026). CONCLUSIONS: Our findings suggest that use of modern hormonal contraceptives may be contributing at least in part to the rise in incidence of MS in women. Additional analyses will be presented at the meeting. Study Supported by: Kaiser Permanente Direct Community Benefit Funds and NIH NINDS (1R01NS075308 PI: Langer-Gould); and Deutsches Forschung's Gemeindschaft Grant, PI Hellwig

Disclosure: Dr. Hellwig has received personal compensation for activities with Bayer Schering, Biogen Idec, Merck Serono, Teva Neuroscience, Aventis Pharmaceuticals Inc., and Novartis. Dr. Hellwig has received research support from the German Research Foundation, Bayer Schering, Biogen Idec, Merck Serono, Novartis, Teva Neuroscience, and Sanofi-Aventis Pharmaceuticals Inc. Dr. Chen has nothing to disclose. Dr. Langer-Gould has received research support from Biogen Idec and Roche.