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Acta Neurol Scand. 2015 May;131(5):336-40. doi: 10.1111/ane.12364. Epub 2015 Jan 18.

Natalizumab discontinuation and disease restart in pregnancy: a case series.

Author information

1
Department of Neurology and Psychiatry, "Sapienza" Unversity of Rome, Rome, Italy.

Abstract

BACKGROUND:

The humanized monoclonal alpha4-integrin antibody Natalizumab (NTZ) (Tysabri(©) , Biogen Idec, Cambridge, MA, USA) has shown to be effective in multiple sclerosis (MS) therapy; however, the interruption of the drug has been related to a disease restart. This risk has to be carefully considered in case of accidental or desired pregnancies.

AIM OF THE STUDY:

To report the risk of disease restart in patients who interrupted NTZ because of pregnancy and discuss the implication of NTZ choice in female childbearing patients with MS.

METHODS:

Clinical histories and MRI images of four pregnant women with MS who interrupted NTZ.

RESULTS:

Despite pregnancy is usually related with disease stability, the cases presented here showed an abrupt increase of disability with high number of MRI lesions, some of them with a mass effect.

CONCLUSIONS:

We recommend that female patients on childbearing age must be informed before starting NTZ treatment of the risk of a return of disease activity when the drug is discontinued. The risk occurs even during pregnancy a condition that is considered as protective for women with MS.

KEYWORDS:

Multiple sclerosis; Natalizumab; Pregnancy

PMID:
25598313
DOI:
10.1111/ane.12364
[Indexed for MEDLINE]

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