TY - JOUR
T1 - Menopause does not modify disability trajectories in a longitudinal cohort of women with clinically isolated syndrome and multiple sclerosis followed from disease onset
AU - Otero-Romero, Susana
AU - Midaglia, Luciana
AU - Carbonell-Mirabent, Pere
AU - Zuluaga, María
AU - Galán, Ingrid
AU - Río, Jordi
AU - Arrambide, Georgina
AU - Rodríguez-Barranco, Marta
AU - Vidal-Jordana, Angela
AU - Castillo, Joaquin
AU - Rodríguez-Acevedo, Breogán
AU - Zabalza, Ana
AU - Nos, Carlos
AU - Comabella-Lopez, Manuel
AU - Mulero, Patricia
AU - Auger, Cristina
AU - Sastre-Garriga, Jaume
AU - Pérez-Hoyos, Santiago
AU - Rovira, Alex
AU - Montalban, Xavier
AU - Tintoré, Mar
N1 - Publisher Copyright:
© 2021 European Academy of Neurology
PY - 2022/4
Y1 - 2022/4
N2 - Background and purpose: To evaluate the effect of menopause on disability accumulation in women followed from their clinically isolated syndrome (CIS). Methods: We examined the longitudinal changes in Expanded Disability Status Scale (EDSS) scores from CIS until the last follow-up in women belonging to the Barcelona CIS prospective cohort, followed through their menopausal transition. The analysis is based on 13,718 EDSS measurements, with an average of 28 EDSS measurements per patient. Differences in EDSS trajectories between menopausal and nonmenopausal women, controlling for age and disease duration, were evaluated. We performed two sensitivity analyses in women with confirmed MS and in those experiencing early menopause. Results: From 764 eligible women, 496 (65%) responded to the questionnaire, and 74 (14.9%) reached menopause over the follow-up. We did not find a significant inflection point in EDSS trajectories around menopause (slope change −0.009; 95% CI −0.066; 0.046). The annual increase in EDSS over the complete course of the disease was significantly higher in menopausal women (0.049; 95% CI, 0.026–0.074) versus nonmenopausal (0.019; 95% CI, 0.008–0.031; interaction p value 0.025). This difference was lost when controlling for age and disease duration (EDSS annual increase of 0.059; 95% CI, 0.025–0.094 vs. 0.038; 95% CI, 0.021–0.057, respectively; interaction p value 0.321). No inflection point was detected when the analysis was restricted to women with confirmed MS or with earlier menopause. Conclusions: Menopause is not associated with an increased risk of disability in a CIS population, considering EDSS trajectories throughout the course of the disease together with age and disease duration.
AB - Background and purpose: To evaluate the effect of menopause on disability accumulation in women followed from their clinically isolated syndrome (CIS). Methods: We examined the longitudinal changes in Expanded Disability Status Scale (EDSS) scores from CIS until the last follow-up in women belonging to the Barcelona CIS prospective cohort, followed through their menopausal transition. The analysis is based on 13,718 EDSS measurements, with an average of 28 EDSS measurements per patient. Differences in EDSS trajectories between menopausal and nonmenopausal women, controlling for age and disease duration, were evaluated. We performed two sensitivity analyses in women with confirmed MS and in those experiencing early menopause. Results: From 764 eligible women, 496 (65%) responded to the questionnaire, and 74 (14.9%) reached menopause over the follow-up. We did not find a significant inflection point in EDSS trajectories around menopause (slope change −0.009; 95% CI −0.066; 0.046). The annual increase in EDSS over the complete course of the disease was significantly higher in menopausal women (0.049; 95% CI, 0.026–0.074) versus nonmenopausal (0.019; 95% CI, 0.008–0.031; interaction p value 0.025). This difference was lost when controlling for age and disease duration (EDSS annual increase of 0.059; 95% CI, 0.025–0.094 vs. 0.038; 95% CI, 0.021–0.057, respectively; interaction p value 0.321). No inflection point was detected when the analysis was restricted to women with confirmed MS or with earlier menopause. Conclusions: Menopause is not associated with an increased risk of disability in a CIS population, considering EDSS trajectories throughout the course of the disease together with age and disease duration.
KW - clinically isolated syndrome
KW - disability
KW - menopause
KW - multiple sclerosis
KW - prognosis
UR - http://www.scopus.com/inward/record.url?scp=85102563436&partnerID=8YFLogxK
U2 - 10.1111/ene.14782
DO - 10.1111/ene.14782
M3 - Article
C2 - 33609298
AN - SCOPUS:85102563436
SN - 1351-5101
VL - 29
SP - 1075
EP - 1081
JO - European Journal of Neurology
JF - European Journal of Neurology
IS - 4
ER -