PT - JOURNAL ARTICLE AU - Kümpfel, Tania AU - Thiel, Sandra AU - Meinl, Ingrid AU - Ciplea, Andrea I. AU - Bayas, Antonios AU - Hoffmann, Frank AU - Hofstadt-van Oy, Ulrich AU - Hoshi, Muna AU - Kluge, Jakob AU - Ringelstein, Marius AU - Aktas, Orhan AU - Stoppe, Muriel AU - Walter, Annette AU - Weber, Martin S. AU - Ayzenberg, Ilya AU - Hellwig, Kerstin TI - Anti-CD20 therapies and pregnancy in neuroimmunologic disorders AID - 10.1212/NXI.0000000000000913 DP - 2021 Jan 01 TA - Neurology - Neuroimmunology Neuroinflammation PG - e913 VI - 8 IP - 1 4099 - http://nn.neurology.org/content/8/1/e913.short 4100 - http://nn.neurology.org/content/8/1/e913.full SO - Neurol Neuroimmunol Neuroinflamm2021 Jan 01; 8 AB - Objective To 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.Methods Data 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); <6M group = RTX/OCR <6 months before the LMP (n = 47); preg group = RTX/OCR after the LMP (n = 13).Results Pregnancy 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.Conclusions Although 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.CA=congenital anomalies; DA=disease activity; DMT=disease-modifying therapy; EA=elective abortion; EDSS=Expanded Disability Status Scale; GW=gestational week; LMP=last menstrual period; mAb=monoclonal antibody; NEMOS=Neuromyelitis Optica Study Group; NMOSD=neuromyelitis optica spectrum disorder; OCR=ocrelizumab; ONID=other neuroimmunologic diseases; RRMS=relapsing-remitting MS; RTX=rituximab; SA=spontaneous abortion