Patients report worse MS symptoms after menopause: Findings from an online cohort

  • R. Bove
    Correspondence
    Correspondence to: Brigham & Women׳s Hospital, Partners Multiple Sclerosis Center, 1 Brookline Place, 2nd Floor, Brookline, MA 02445, USA. Tel.: +1 617 525 6550; fax: +1 617 525 5333.
    Affiliations
    Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women׳s Hospital, Brookline, MA 02445, USA

    Harvard Medical School, Boston, MA 02115, USA

    Center for Neurologic Diseases, Harvard Medical School, 77 Avenue Louis Pasteur, NRB168, Boston, MA 02115, USA
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  • B.C. Healy
    Affiliations
    Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women׳s Hospital, Brookline, MA 02445, USA

    Harvard Medical School, Boston, MA 02115, USA

    Center for Neurologic Diseases, Harvard Medical School, 77 Avenue Louis Pasteur, NRB168, Boston, MA 02115, USA

    Massachusetts General Hospital Biostatistics Center, Boston, MA 02114, USA
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  • E. Secor
    Affiliations
    Center for Neurologic Diseases, Harvard Medical School, 77 Avenue Louis Pasteur, NRB168, Boston, MA 02115, USA
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  • T. Vaughan
    Affiliations
    PatientsLikeMe, Inc., Cambridge, MA, USA
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  • B. Katic
    Affiliations
    PatientsLikeMe, Inc., Cambridge, MA, USA
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  • T. Chitnis
    Affiliations
    Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women׳s Hospital, Brookline, MA 02445, USA

    Harvard Medical School, Boston, MA 02115, USA

    Center for Neurologic Diseases, Harvard Medical School, 77 Avenue Louis Pasteur, NRB168, Boston, MA 02115, USA
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  • P. Wicks
    Affiliations
    PatientsLikeMe, Inc., Cambridge, MA, USA
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  • P.L. De Jager
    Affiliations
    Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women׳s Hospital, Brookline, MA 02445, USA

    Harvard Medical School, Boston, MA 02115, USA

    Center for Neurologic Diseases, Harvard Medical School, 77 Avenue Louis Pasteur, NRB168, Boston, MA 02115, USA
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Published:December 09, 2014DOI:https://doi.org/10.1016/j.msard.2014.11.009

      Highlights

      • We leveraged a patient-powered research platform to rapidly test a research hypothesis.
      • Prospectively collected MS severity scores were more severe after menopause.
      • Women with early, surgical menopause had worse MS severity scores.
      • These findings require validation in clinical cohorts.

      Abstract

      Background

      Many women with multiple sclerosis (MS) are postmenopausal, yet the impact of menopause on MS symptoms is unknown.

      Objective

      To investigate patient-reported impact of menopause in a large online research platform, PatientsLikeMe (PLM).

      Methods

      A detailed reproductive history survey was deployed to PLM members, and responses were linked to PLM׳s prospectively collected patient-reported severity score (MS Rating Scale, MSRS). The MSRS has previously shown good correlation with physician-derived EDSS scores.

      Results

      Of the 513 respondents, 55% were postmenopausal; 54% of these reported induced menopause. Median age at natural menopause was 51. Surgical menopause occurred at an earlier age (p<0.001) and was associated with more hormone replacement therapy use (p=0.02) than natural menopause. Postmenopausal status, surgical menopause, and earlier age at menopause were all associated with worse MSRS scores (p≤0.01) in regressions adjusting for age, disease type and duration.

      Conclusion

      Postmenopausal patients in this study reported worse MS disease severity. Further, this study highlights a utility for online research platforms, which allow for rapid generation of hypotheses that then require validation in clinical settings.

      Keywords

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