Natalizumab use during the third trimester of pregnancy.
JAMA Neurol
; 71(7): 891-5, 2014 Jul 01.
Article
in En
| MEDLINE
| ID: mdl-24821217
ABSTRACT
IMPORTANCE Natalizumab reduces multiple sclerosis relapses very effectively; however, severe disease activity may return once natalizumab treatment is withdrawn, as recommended during pregnancy. Sometimes restarting natalizumab treatment may be the best option for the mother, but the consequences for the infant are unknown. Except for a few single case reports, to our knowledge, comprehensive data about third-trimester natalizumab exposure are scant. OBSERVATIONS In a case series of 12 women with 13 pregnancies and highly active multiple sclerosis who were treated with natalizumab during their third trimester of pregnancy, we assessed the clinical and laboratory effects on the newborns. We observed mild to moderate hematologic alterations in 10 of 13 infants including thrombocytopenia and anemia. In a subsample of 5 mother-child pairs, we analyzed natalizumab levels in the umbilical cord blood. Natalizumab was detectable in all 5 newborns. CONCLUSION AND RELEVANCE Natalizumab can be a therapeutic option in patients with highly active multiple sclerosis during pregnancy. We recommend that a pediatrician be available at the time of delivery to evaluate for potential complications of anemia and thrombocytopenia in newborns exposed to natalizumab during the third trimester.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pregnancy Complications, Hematologic
/
Pregnancy Trimester, Third
/
Antibodies, Monoclonal, Humanized
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Infant, Newborn, Diseases
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Multiple Sclerosis
Limits:
Adult
/
Animals
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Female
/
Humans
/
Newborn
/
Pregnancy
Language:
En
Journal:
JAMA Neurol
Year:
2014
Document type:
Article
Affiliation country:
Alemania