Anti-CD20 therapies and pregnancy in neuroimmunologic disorders
| Autor: | Kerstin Hellwig, Jakob Kluge, Antonios Bayas, Orhan Aktas, Martin S. Weber, Marius Ringelstein, Tania Kümpfel, Muriel Stoppe, Frank Hoffmann, Ingrid Meinl, Ilya Ayzenberg, Muna Hoshi, Sandra Thiel, Annette Walter, Ulrich Hofstadt-van Oy, Andrea I. Ciplea |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Pregnancy medicine.medical_specialty Neuromyelitis optica business.industry Obstetrics medicine.disease 3. Good health 03 medical and health sciences 030104 developmental biology 0302 clinical medicine Neurology medicine Gestation Rituximab Ocrelizumab In patient ddc:610 Neurology (clinical) Anti cd20 business 030217 neurology & neurosurgery medicine.drug Cohort study |
| Zdroj: | Neurology - Neuroimmunology Neuroinflammation. 8:e913 |
| ISSN: | 2332-7812 |
| DOI: | 10.1212/nxi.0000000000000913 |
| Popis: | ObjectiveTo report pregnancy outcomes and disease activity (DA) in women with MS, neuromyelitis optica spectrum disorders (NMOSDs), and other neuroimmunologic diseases (ONID) after treatment with rituximab (RTX)/ocrelizumab (OCR) 12 months before or during pregnancy.MethodsData were collected in the German MS and pregnancy registry and centers from the Neuromyelitis Optica Study Group. Sixty-eight known outcomes of 88 pregnancies from 81 women (64 MS, 10 NMOSD, and 7 ONID) were included and stratified in 3 exposure groups: >6M-group = RTX/OCR >6 but ≤12 months before the last menstrual period (LMP) (n = 8); ResultsPregnancy outcomes were similar between groups, but significantly more preterm births (9.8% vs 45%) occurred after exposure during pregnancy. Overall, 2 major congenital abnormalities (3.3%), both in the preg group, were observed. Three women had severe infections during pregnancy. All women with MS (35) and 12/13 women with NMOSD, RTX/OCR exposure before the LMP and known pregnancy outcomes after gestational week 22 were relapse free during pregnancy. Five of 29 (17.2%) women with relapsing-remitting MS (RRMS) and 1 of 12 (8.3%) with NMOSD and at least 6 months postpartum follow-up experienced a relapse postpartum. Duration of RTX/OCR and early retreatment but not detection of B-cells were possible predictors for postpartum relapses in patients with RRMS/NMOSD.ConclusionsAlthough RTX/OCR might be an interesting option for women with RRMS/NMOSD who plan to become pregnant to control DA, more data on pregnancy outcomes and rare risks are needed. |
| Databáze: | OpenAIRE |
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