Natalizumab discontinuation and disease restart in pregnancy: a case series. (18th January 2015)

• Record Type: Journal Article
• Authors: De Giglio, L.; Gasperini, C.; Tortorella, C.; Trojano, M.; Pozzilli, C.
• Is Part Of: Acta neurologica Scandinavica. Volume 131:Number 5(2015:May)
• Page Start: 336
• Page End: 340
• Publication Date: 2015-01-18
• Subjects: Neurology -- Periodicals; 616.8
• DOI: 10.1111/ane.12364
• Languages: English
• ISSNs: 0001-6314

Abstract

<abstract abstract-type="main" id="ane12364-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ane12364-sec-0001" sec-type="section"> <title>Background</title> <p>The humanized monoclonal alpha4‐integrin antibody Natalizumab (NTZ) (Tysabri<sup>©</sup>, 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.</p> </sec> <sec id="ane12364-sec-0002" sec-type="section"> <title>Aim of the study</title> <p>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.</p> </sec> <sec id="ane12364-sec-0003" sec-type="section"> <title>Methods</title> <p>Clinical histories and MRI images of four pregnant women with MS who interrupted NTZ.</p> </sec> <sec id="ane12364-sec-0004" sec-type="section"> <title>Results</title> <p>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.</p> </sec> <sec id="ane12364-sec-0005" sec-type="section"> <title>Conclusions</title> <p>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.</p> </sec> </abstract>