Publications by authors named "Klaus Gregaard Madsen"

5 Publications

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Incidence of pregnancy and disease-modifying therapy exposure trends in women with multiple sclerosis: A contemporary cohort study.

Mult Scler Relat Disord 2019 Feb 3;28:235-243. Epub 2019 Jan 3.

Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, Alfred Hospital, Melbourne, Australia; Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Melbourne, Australia. Electronic address:

Background: Exposure to disease-modifying therapy (DMT) during early pregnancy in women with relapsing-remitting MS (RRMS) may be increasing.

Objective: To retrospectively determine incidence of pregnancy, DMT exposure and pregnancy outcomes in women with RRMS.

Methods: We identified all women with RRMS aged 15-45 years in the MSBase Registry between 2005-2016. Annualised pregnancy incidence rates were calculated using Poisson regression models. DMT exposures and pregnancy outcomes were assessed.

Results: Of 9,098 women meeting inclusion criteria, 1,178 (13%) women recorded 1,521 pregnancies. The annualised incidence rate of pregnancy was 0.042 (95% CI 0.040, 0.045). A total of 635 (42%) reported pregnancies were conceived on DMT, increasing from 27% in 2006 to 62% in 2016. The median duration of DMT exposure during pregnancy was 30 days (IQR: 9, 50). There were a higher number of induced abortions on FDA pregnancy class C/D drugs compared with pregnancy class B and no DMT (p = 0.010); but no differences in spontaneous abortions, term or preterm births.

Conclusions: We report low pregnancy incidence rates, with increasing number of pregnancies conceived on DMT over the past 12-years. The median duration of DMT exposure in pregnancy was relatively short at one month.
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http://dx.doi.org/10.1016/j.msard.2019.01.003DOI Listing
February 2019

Patient awareness about family planning represents a major knowledge gap in multiple sclerosis.

Mult Scler Relat Disord 2018 Aug 15;24:129-134. Epub 2018 Jun 15.

Biogen Denmark A/S, Stationsparken 37, 3rd floor, Glostrup DK-2600, Denmark.

Background: The purpose of the survey was to assess the knowledge of family planning issues associated with disease modifying therapies (DMTs) among patients diagnosed with multiple sclerosis (MS).

Methods: 590 Danish MS patients responded to an online questionnaire about family planning in MS, collecting demographics, disease characteristics, disease modifying treatment, knowledge of potential teratogenic effects in DMTs, number of children, occurrence of unplanned pregnancies and outcome, and sources of information.

Results: 488 females and 102 males, mean age 40 years, responded. On average, it was 6.5 and 10.9 years since diagnosis and first symptoms, respectively. 16% of female and 19% of male respondents did not receive DMT at the time of responding to the survey. 30% of all had received only one DMT, 37%, 19%, 8%, and 5% had received two, three, four, and five different treatments, respectively. 42% of female and 74% of male respondents said they did not know if the medication they were taking had teratogenic risks. 83% of females and 85% of males responded that they did not know, whether DMT in male MS patients may expose healthy partners to teratogenic risks; hereto, 13% and 10%, respectively, answered that no transmission occurs. On average respondents had two children; three of four children reported in the study were born prior to the respondents being diagnosed with MS. 50% of both female and male respondents without children wanted a family and 25% of females and 16% of males wanted to start a family within the next two years. 91% of female respondents would discontinue DMT during pregnancy. Among male respondents 32% would continue treatment during a partner's pregnancy and 47% did not know whether they would continue or discontinue treatment. 10% of the female patients had had unplanned pregnancies during MS treatment, of these 49% chose to have an abortion. 53% of all felt they were well informed about MS treatment and family planning. 22% and 41% of the respondents received information from the neurologist about teratogenic risks in female MS patients and about teratogenic risks in women with male MS patients as partners, respectively; 27% and 34%% retrieved information from the internet on these two issues.

Conclusion: This survey uncovered a low level of knowledge about DMTs' teratogenic risks among MS patients irrespective of sex. Knowledge about potential teratogenic risks for male MS patients receiving DMTs while planning to start a family was largely absent. 10% of female patients had experienced unplanned pregnancies on MS treatment. In general, patients use the internet and their neurologist to the same extent for information on parenthood planning.
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http://dx.doi.org/10.1016/j.msard.2018.06.006DOI Listing
August 2018

The nasal mucosa contains a large spectrum of human papillomavirus types from the Betapapillomavirus and Gammapapillomavirus genera.

J Infect Dis 2013 Oct 21;208(8):1335-41. Epub 2013 Jul 21.

Department of Laboratory Medicine, Division of Medical Microbiology, Lund University, Malmö, Sweden.

Background:  Human papillomavirus (HPV) types from the Betapapillomavirus and Gammapapillomavirus genera are common at cutaneous sites. The aim of this study was to analyze the prevalence of these HPV types in oral and nasal samples.

Methods:  Nasal samples and oral samples were obtained from 312 volunteer Danish healthcare staff (240 women and 72 men), among whom the mean age was 42 years. A total of 311 oral samples and 304 nasal samples were eligible for HPV DNA analysis. HPV types were detected by use of polymerase chain reactions with modified general primers (MGP) and Forslund-Antonsson primers (FAP) and identified by Luminex (for types detected by MGP PCR) or direct sequencing or cloning before sequencing (for types detected by FAP PCR).

Results:  HPV DNA was detected in 6% of the oral samples and 50% of the nasal samples. Seventy-five diverse HPV types or putative HPV types were identified. HPV types within the Alphapapillomavirus, Betapapillomavirus, and Gammapapillomavirus genera were detected in 3%, 31%, and 23% of the nasal samples, respectively. A putative subtype of HPV76, originally isolated from a feline oral squamous cell carcinoma, was detected in 7 nasal samples.

Conclusion:  A large spectrum of HPV types from Betapapillomavirus and Gammapapillomavirus have tropism for the nasal mucosa. The implication of the relatively high prevalence of these viruses in the nasal mucosa is unknown.
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http://dx.doi.org/10.1093/infdis/jit326DOI Listing
October 2013

[Herpes zoster incidence in persons above 50 years of age].

Ugeskr Laeger 2009 Jun;171(26):2194-7

Danske Laegers Forsknings Center A/S, DK-2860 Søborg.

Introduction: Following the development of herpes zoster vaccines and the potential socio-economic benefits hereof, it is relevant to conduct a study concerning epidemiological aspects of the disease based on a Danish population.

Material And Methods: Structured telephone interviews with 1207 persons above 50 years of age were conducted in order to determine the cumulated incidence proportion of herpes zoster in the age groups 50-66 years, 66-70 years and 71+.

Results: The cumulated incidence proportion of herpes zoster was 8.9%, 12.5%, 16.0% in the age groups 50-65 years, 65-70 years and 71+, respectively. Herpes zoster was positively associated with female sex, hypertension, hypercholesterolemia and prescription medicine; however, only the former remained significant after test in a multiple logistic regression model.

Conclusion: Herpes zoster is common among persons who are more than 50 years old and most frequent among women.
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June 2009

[Knowledge of human papilloma virus-associated disease among women in general practice].

Ugeskr Laeger 2009 Mar;171(14):1173-7

Sanofi Pasteur MSD, Parallelvej 12, DK-2800 Lyngby.

Introduction: Cervical cancer is caused by oncogenic human papilloma virus (HPV) serotypes. Types 16 and 18 are responsible for approximately 75% of all cases in Europe. Low-malignant serotypes like HPV 6 and 11 are the cause of approximately 90% of all cases of conyloma accuminata. Approximately 75% of the adult population has or will become infected by one or more HPV serotypes. The purpose of the study was to investigate the level of knowledge of the cause of cervical cancer, cervical dysplasia and condylomas among women seen in Danish general practice, and to investigate the women's expectations to communication with regard to prophylactic initiatives and, finally, to determine which aspects would influence their wish for HPV-vaccination.

Material And Methods: Patient questionnaire in 26 general practices between September 2006 through February 2007.

Results: A total of 425 women aged 14-39 years were included in the study. Only 1.2% of the women correctly stated HPV as the cause of cervical cancer and 0.7% stated HPV as the cause of condylomas. In all, 96.2% thought that general practitioners should actively inform their patients of prophylactic initiatives such as vaccination against cervical cancer. Among all women, 96.4% considered HPV-vaccination.

Conclusion: In this population, knowledge about the cause of cervical cancer and condylomas was limited. There was a clear wish - and expectation - to be actively informed on prophylactic initiatives by the general practitioner.
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March 2009