| Title: |
Disease Activity in Pregnant and Postpartum Women with Multiple Sclerosis Receiving Ocrelizumab or Other Disease-Modifying Therapies |
| Authors: |
Yeh, WZ; Van Der Walt, A; Skibina, OG; Kalincik, T; Alroughani, R; Kermode, AG; Fabis-Pedrini, MJ; Carroll, WM; Lechner-Scott, J; Boz, C; Ozakbas, S; Buzzard, K; Habek, M; John, NA; Prat, A; Girard, M; Duquette, P; Baghbanian, SM; Hodgkinson, S; Van Pesch, V; Laureys, G; Willekens, B; Prevost, J; Foschi, M; De Gans, K; Horakova, D; Havrdova, EK; Karabudak, R; Patti, F; McCombe, PA; Maimone, D; Altintas, A; Ampapa, R; Spitaleri, D; Gerlach, OHH; Sa, MJ; Hughes, S; Gouider, R; Mrabet, S; MacDonell, RA; Turkoglu, R; Cartechini, E; Al-Asmi, A; Soysal, A; Oh, J; Muros-Le Rouzic, E; Guye, S; Pasquarelli, N; Butzkueven, H; Jokubaitis, VG; Barnett, M; Slee, M; Van Hijfte, L; Yamout, B; Terzi, M; Blanco, Y; Grammond, P; Izquierdo, G; Besora, S; Taylor, B; Castillo-Triviño, T; Sanchez-Menoyo, JL; Lugaresi, A; Amato, MP; Hardy, T; Decoo, D; Fragoso, Y; Iuliano, G; Gray, O; Saladino, ML; Grand'Maison, F; Sempere, AP; Shaw, C; Van Wijmeersch, B; Csepany, T; Solaro, C; Alkhaboori, J; Garber, J; Dominguez, JA; Piroska, I; McGuigan, C; Cauchi, M; Skromne, E; Treviño-Frenk, I; Mason, D; Sirbu, CA; Etemadifar, M; Nohara, C; Cambron, M; De Vecino, MCA; Shalaby, N; Field, D; Aguera-Morales, E; Khurana, D; Matsumoto, R; Shimizu, F; Sinnige, LGF; Cárdenas-Robledo, S |
| Publisher Information: |
LIPPINCOTT WILLIAMS & WILKINS |
| Publication Year: |
2024 |
| Collection: |
The University of Melbourne: Digital Repository |
| Description: |
BACKGROUND AND OBJECTIVES: Women with multiple sclerosis (MS) are at risk of disease reactivation in the early postpartum period. Ocrelizumab (OCR) is an anti-CD20 therapy highly effective at reducing MS disease activity. Data remain limited regarding use of disease-modifying therapies (DMTs), including OCR, and disease activity during peripregnancy periods. METHODS: We performed a retrospective cohort study using data from the MSBase Registry including pregnancies conceived after December 31, 2010, from women aged 18 years and older, with relapsing-remitting MS or clinically isolated syndrome. Women were classified by preconception exposure to DMTs, including OCR, rituximab (RTX), natalizumab (NAT), stratified into active (NAT-A; continued ≥28 weeks of gestation, restarted ≤1 month postpartum) or conservative (NAT-C; continued ≤4 weeks of gestation, restarted >1 month postpartum) strategies, dimethyl fumarate (DMF) or low-efficacy DMTs (interferon-beta, glatiramer acetate). Annualized relapse rates (ARRs) were calculated for 12-month prepregnancy, pregnancy, and 6-month postpartum periods. RESULTS: A total of 2,009 live births from 1,744 women were analyzed, including 73 live births from 69 women treated with preconception OCR. For OCR, no within-pregnancy relapse was observed and 3 women (4.1%) experienced 1 relapse in the postpartum period (ARR 0.09 [95% CI 0.02-0.27]). For NAT-A, 3 (3.7%) of 82 women relapsed during pregnancy (0.05 [0.01-0.15]) and 4 (4.9%) relapsed during postpartum (0.10 [0.03-0.26]). However, for NAT-C, 13 (15.9%) of 82 women relapsed within pregnancy (0.32 [0.20-0.51]) and 25 (30.5%) relapsed during postpartum (0.74 [0.50-1.06]). In the low-efficacy DMT group, 101 (7.6%) of 1,329 women experienced within-pregnancy relapse (0.12 [0.10-0.14]), followed by an increase in postpartum relapse activity with 234 women (17.6%) relapsing (0.43 [0.38-0.48]). This was similarly seen in the DMF group with 13 (7.9%) of 164 women experiencing within-pregnancy relapse (0.12 [0.06-0.20]) and 25 ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISSN: |
2332-7812 |
| Relation: |
https://hdl.handle.net/11343/359059 |
| Availability: |
https://hdl.handle.net/11343/359059 |
| Rights: |
https://creativecommons.org/licenses/by-nc-nd/4.0 ; CC BY-NC-ND |
| Accession Number: |
edsbas.147F58F7 |
| Database: |
BASE |