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Mult Scler. 2015 Jun;21(7):953-5. doi: 10.1177/1352458514554056. Epub 2014 Oct 10.

Natalizumab for the prevention of post-partum relapses in women with multiple sclerosis.

Author information

1
Service de Neurologie A and Fondation Eugène Devic EDMUS contre la Sclérose en Plaques, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France/Centre des Neurosciences de Lyon, INSERM 1028 et CNRS UMR5292, Equipe Neuro-oncologie et Neuro-inflammation, Lyon, France/Université de Lyon, Lyon, France/Université Lyon 1, Lyon, France sandra.vukusic@chu-lyon.fr.
2
Service de Neurologie A and Fondation Eugène Devic EDMUS contre la Sclérose en Plaques, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.
3
Service de Neurologie A and Fondation Eugène Devic EDMUS contre la Sclérose en Plaques, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France/Centre des Neurosciences de Lyon, INSERM 1028 et CNRS UMR5292, Equipe Neuro-oncologie et Neuro-inflammation, Lyon, France/Université de Lyon, Lyon, France/Université Lyon 1, Lyon, France.

Abstract

OBJECTIVE:

Our aim was to evaluate the impact of early redosing of natalizumab after delivery on the risk of post-partum relapses in six women with very active multiple sclerosis (MS).

METHODS:

We undertook a retrospective analysis of data collected prospectively in the Lyon MS Cohort.

RESULTS:

The annualized relapse rate (ARR) in the year before natalizumab treatment was 4.2 ±0.4, which decreased to 0.4 ±0.6 during the treatment period. The mean time between natalizumab withdrawal and onset of pregnancy was 9 months; one pregnancy was exposed to one infusion. The ARR between natalizumab withdrawal and onset of pregnancy was 1.8 ±0.7. Six relapses occurred before onset of pregnancy and seven during pregnancy. Natalizumab was restarted 7.8 days after delivery (between day 2 and 8 for five patients and on day 23 for one). Only one patient, who had restarted natalizumab 2 days after delivery, had a relapse 2 weeks later. The others five patients were relapse free after a mean of 14.2 ±9.1 months of follow-up.

CONCLUSION:

Despite a high risk of post-partum relapses, early redosing of natalizumab led to a complete disappearance of disease activity in all but one patient. These data suggest that natalizumab could be a good candidate for preventing early post-partum relapses.

KEYWORDS:

Multiple sclerosis; natalizumab; post-partum; pregnancy; relapses

PMID:
25305253
DOI:
10.1177/1352458514554056
[Indexed for MEDLINE]

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