Abstract Details

Title The use natalizumab in multiple sclerosis patients during pregnancy is safe and prevents disease reactivation

Topic Multiple Sclerosis

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-093

Objective

To assess the effectiveness and safety of natalizumab in Multiple Sclerosis (MS) patients during pregnancy

Background

Natalizumab has been used in selected highly active MS patients during pregnancy as an off-label indication. Data of the use of natalizumab during pregnancy is limited.

Design/Methods

Data of women using natalizumab was extracted from the national registry. The cohort constituted 3 groups; patients continued natalizumab during pregnancy till 28^thgestational week (group 1), patients discontinued natalizumab before pregnancy (group 2) and a control group that included women who did not get pregnant (group 3). Demographics and clinical characteristics of the three groups were assessed. Clinical (relapses) and radiological (MRI new T2/ gad-enhancing lesions) data during pregnancy and at one-year post delivery were compared

Results 68 patients were identified; group 1 (n=14), group 2 (n=14), and group 3 (n=40). At baseline, there were no significant differences across the three groups in mean age (p= 0.07), mean age at onset (p= 0.44), mean disease duration (p= 0.21), annualized relapse rate (p= 0.27) and MRI measures (p= 0.25). The mean number of natalizumab infusions was 44 ± 26.05. During pregnancy, no relapses occurred in group 1 while four patients (28.6%) sustained relapses in group 2 (p = 0.03). At last follow-up visit, annual relapse rate was significantly higher in group 2 (0.75 ± 0.51), compared to groups 1 & 3 (0.14 ± 0.36 & 0.05 ± 0.22; p < 0.001) respectively. The proportion of patients with MRI activity was significantly higher in group 2 compared to groups 1 and 3 (50%, 7.1%, and 2.5%; p= 0.03). Abortion rate was not statistically significant between group 1 and 2 (p= 0.47)and no fetal malformation was observed.

Conclusions Patients who continued using natalizumab during pregnancy remained in remission while natalizumab discontinuation resulted in disease reactivation. The use of natalizumab during pregnancy was safe in our cohort

Authors/Disclosures
Raed Alroughani, MD, FAAN PRESENTER	Dr. Alroughani has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen, AstraZeneca, Novartis, Merck, Roche, Sanofi. Dr. Alroughani has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for AstraZeneca, Biogen, Novartis, Merck, Roche, Sanofi.
Samar F. Ahmed, MD	Dr. Ahmed has nothing to disclose.
	No disclosure on file
Jasem Y. Al-Hashel, MD (IBN Sina Hospital, AlSabah Medical Area, Neurology Department)	Dr. Al-Hashel has nothing to disclose.

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