RT Journal Article
SR Electronic
T1 Disease activity following pregnancy-related discontinuation of natalizumab in MS
JF Neurology - Neuroimmunology Neuroinflammation
JO Neurol Neuroimmunol Neuroinflamm
FD Lippincott Williams & Wilkins
DO 10.1212/NXI.0000000000000424
VO 5
IS 1
A1 Kleerekooper, Iris
A1 van Kempen, Zoé L.E.
A1 Leurs, Cyra E.
A1 Dekker, Iris
A1 Rispens, Theo
A1 Lissenberg-Witte, Birgit I.
A1 van Munster, Caspar E.P.
A1 de Jong, Brigit A.
A1 van Oosten, Bob W.
A1 Uitdehaag, Bernard M.J.
A1 Wattjes, Mike P.
A1 Killestein, Joep
YR 2018
UL http://nn.neurology.org/content/5/1/e424.abstract
AB Objective: To investigate disease activity and disability progression following pregnancy-related discontinuation of natalizumab (NTZ) in patients with relapsing-remitting MS.Methods: A retrospective cohort study of clinical and radiologic data in patients who discontinued NTZ for pregnancy-related reasons.Results: Twenty-two pregnancy-related NTZ discontinuations in 17 patients were evaluated. The median time to conception was 3.4 months. Relapses were more frequent in patients in whom conception did not occur within 6 months (p = 0.022). Confirmed disability progression occurred in 27.3% and was associated with time to conception (p < 0.001).Conclusions: Early conception after NTZ discontinuation is associated with a reduced risk of disease activity and disability progression. Continuation of NTZ treatment until confirmed pregnancy should be considered in patients with previously active MS. However, the advantages of continuing the drug until pregnancy should be balanced against the uncertainties in postnatal outcomes.ARR=annualized relapse rate; DMT=disease-modifying treatment; EDSS=Expanded Disability Status Scale; NTZ=natalizumab; RRMS=relapsing-remitting MS