Effect on Cognition of Estroprogestins Combined with Interferon Beta in Multiple Sclerosis: Analysis of Secondary Outcomes from a Randomised Controlled Trial

Giglio, Laura De; Marinelli, F.; Barletta, Valeria; Pagano, Veronica Anna; Angelis, Floriana De; Fanelli, Fulvia; Petsas, Nikolaos; Pantano, P.; Tomassini, Valentina; Pozzilli, Carlo

doi:10.1007/s40263-016-0401-0

Cited by 28 publications

(22 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This was represented by estroprogestinic oral contraceptives whose exact dosage and duration of intake were, however, not recorded. A few randomized clinical trials have reported positive effects of estrogen therapy on cognitive performance [38–42] and the topic has been extensively reviewed elsewhere [43,44]. In animal studies the estrogens has been showed to have task-specific effects on cognitive performance and these effects might be influenced by age and time after loss of ovarian function [45].…”

Section: Discussionmentioning

confidence: 99%

Cognitive impairment in multiple sclerosis: An exploratory analysis of environmental and lifestyle risk factors

et al. 2019

View full text Add to dashboard Cite

BackgroundMany potentially modifiable risk factors for MS are investigated. It is not known, however, if these factors also apply to MS-related cognitive impairment (CI), a frequent consequence of MS.ObjectiveThe aim of our study was to assess risk factors for CI in MS patients, focusing on environmental exposures, lifestyle and comorbidities.MethodsWe included MS patients referring to MS Centers in Florence and Barletta between 2014 and 2017. Neuropsychological performance was assessed through the Rao’s battery and Stroop test, cognitive reserve (premorbid intelligence quotient–IQ) was evaluated using the National Adult Reading Test (NART). Potential risk factors were investigated through a semi-structured questionnaire.Results150 patients were included. CI was detected in 45 (30%) subjects and was associated with older age (p<0.005), older age at MS onset (p = 0.016), higher EDSS score (p<0.005), progressive disease course (p = 0.048) and lower premorbid IQ score (p<0.005). As for risk factors, CI was related with lower physical activity in childhood-adolescence (p<0.005). In women, hormonal therapy resulted to be protective against CI (p = 0.041). However, in the multivariable analysis, the only significant predictors of CI were older age (p<0.05; OR 1.06, 95% CI 1.02–1.10) and lower premorbid IQ (p<0.05; OR 0.93, 95% CI: 0.88–0.98). Removing IQ from the model, CI was associated with higher EDSS (p = 0.030; OR 1.25, 95% CI 1.02–1.53) and, marginally, previous physical activity (p = 0.066; OR 0.49, 95% CI: 0.23–1.05)ConclusionsOur findings suggest that physical activity in childhood-adolescence could be a contributor to cognitive reserve building, thus representing a potential protective factors for MS-related CI susceptible to preventive strategies.

show abstract

Section: Discussionmentioning

confidence: 99%

Cognitive impairment in multiple sclerosis: An exploratory analysis of environmental and lifestyle risk factors

et al. 2019

View full text Add to dashboard Cite

show abstract

“…However, this MRI outcome was not a prespecified primary endpoint, and there was no benefit on relapse rate or disability, the 2 primary endpoints. Another exploratory finding in the estradiol-containing oral contraceptive pill (OCP) trial was that the 40-mg dose was associated with better cognitive performance versus placebo, whereas the 20-mg dose was not [37]. Together these data reinforce the importance of estrogen type and dose in modifying MS.…”

Section: Clinical Trials Aiming To Simulate the Protection Of Pregnanmentioning

confidence: 95%

Pregnancy: Effect on Multiple Sclerosis, Treatment Considerations, and Breastfeeding

Voskuhl

Momtazee

2017

Neurotherapeutics

View full text Add to dashboard Cite

Multiple sclerosis (MS) commonly affects women in childbearing years making pregnancy issues important for patients with MS and their families. Pregnancy is a naturally occurring disease modifier of MS associated with a 70% reduction in relapse rates in the third trimester. This relapse rate reduction during the last trimester is roughly equal to the most effective disease-modifying treatments for MS. Given this efficacy, various pregnancy factors have been tested to determine which play a part in pregnancy's protection, and some have been translated to completed and ongoing phase II clinical trials. In contrast to protective effects during pregnancy, the postpartum period entails increased relapse risk, which may be due to either abrupt removal of protective pregnancy factors after delivery or to unique deleterious factors inherent to the postpartum period. The effect of breastfeeding on MS remains unclear. The best predictor for whether a patient will have a postpartum relapse is the incidence of her having active relapsing MS prior to pregnancy. The medical management of MS during pregnancy and the postpartum period is challenging given the risks of medication exposure to the fetus in utero and to the infant through breast milk. This review will focus on clinical aspects of pregnancy, including the effects of pregnancy on MS disease activity, as well as the medical management of MS during pregnancy and postpartum.

show abstract

“…Roles for sex hormones in sex differences have been studied extensively in preclinical MS models 36 and are being investigated in MS clinical trials. 37–39 A role for sex chromosomes has been less well studied in EAE and is not mutually exclusive of a role for sex hormones. In preclinical models of disease, gonadectomy to remove effects of sex hormones does not suffice to study sex chromosome effects since differences between gonadectomized female and male mice are confounded by organizational effects of sex hormones from birth to the time of gonadectomy.…”

Section: A Model To Ascertain Sex Chromosome Effects On Diseasementioning

confidence: 99%

Sex chromosome contributions to sex differences in multiple sclerosis susceptibility and progression

2018

View full text Add to dashboard Cite

show abstract

Effect on Cognition of Estroprogestins Combined with Interferon Beta in Multiple Sclerosis: Analysis of Secondary Outcomes from a Randomised Controlled Trial

Cited by 28 publications

References 33 publications

Cognitive impairment in multiple sclerosis: An exploratory analysis of environmental and lifestyle risk factors

Cognitive impairment in multiple sclerosis: An exploratory analysis of environmental and lifestyle risk factors

Pregnancy: Effect on Multiple Sclerosis, Treatment Considerations, and Breastfeeding

Sex chromosome contributions to sex differences in multiple sclerosis susceptibility and progression

Contact Info

Product

Resources

About