Preventive use of COrticosteroids during the Post-Partum in relapsing MS patients - Laure Michel, 2018.


Multiple Sclerosis (MS) is most prevalent among women of childbearing age. The post-partum (PP) period is a critical phase in MS patients, during which a recrudescence of disease activity is expected. Different strategies have been assessed in the prevention of post-partum relapse. High dose methylprednisolone was evaluated in a case control study with historical controls but the positive results have not been confirmed.

In this study, the main objective will be to compare the risk of relapse in the 6 months PP period between (1) patients treated systematically by high dose methylprednisolone after delivery compared to (2) patients who didn’t receive a systematic treatment. Our second objective will be focused on the comparison of the disease activity and disability progression in patients who have resumed early a Disease Modifying Drug (DMD) after delivery vs patients who haven’t.

This study will be an observational multicentre retrospective study using data collected prospectively. Participating centre will be Rennes, Nice, Nantes, Lyon and Strasbourg. These centres have been selected because of their different strategies to prevent PP relapse: Nice and Strasbourg treat systematically MS patients after delivery by high dose methylprednisolone while the others centres don’t.

First, descriptive statistics will be presented for the study population, overall, and according to our groups of interest in each objective. Then, propensity scores will be used as a weight based on the stabilized inverse probability of treatment weighting. Taking into account this weight on the studied sample will give a weighted sample that will be studied using different statistical analysis according to the endpoints.