Abstract Details

Title Unexpected Pregnancy in a Patient with NMOSD after Treatment with Inebilizumab: A Case Report

Topic Autoimmune Neurology

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 2-005

Objective To fill the evidence gap regarding the use of inebilizumab in pregnant patients with neuromyelitis optica spectrum disorder (NMOSD) and provide detailed data on its application as well as the long-term outcomes for mothers, fetuses, and the disease.

Background NMOSD is an autoimmune disease characterized by inflammatory demyelinating lesions affecting the optic nerve and spinal cord. As a rare condition, its clinical management—particularly in special populations such as pregnant patients—remains challenging. Inebilizumab, a B-cell-depleting biological agent in NMOSD treatment, has demonstrated efficacy in disease control. However, no prior clinical reports have described its use in pregnant patients or the associated long-term maternal, fetal, and disease outcomes, leaving a critical gap.

Design/Methods /

Results We report a female patient with anti-AQP4antibody-positive NMOSD who experienced an unplanned pregnancy during three cycles of inebilizumab maintenance therapy. A multidisciplinary team (neurologists, obstetricians, and immunologists) collaborated to develop an individualized treatment plan. Following confirmation of pregnancy, her therapy was adjusted to low-dose methylprednisolone combined with azathioprine. During pregnancy, monitoring revealed persistently low B-cell counts, with low anti-AQP4 antibody titers in the second trimester. A successful cesarean section was performed at 38 weeks and 5 days, resulting in a safe delivery for both mother and baby. On the 11th day postpartum, she received 300 mg of inebilizumab treatment. There were no relapses or infections during the entire pregnancy and three months postpartum.

Conclusions This first reported case provides novel evidence that inebilizumab-induced B-cell depletion exerts a sustained effect, contributing to stable NMOSD control throughout pregnancy and the post-partum period. It also offers pioneering clinical insights into managing biological agents in special populations such as pregnant patients, highlighting that safe treatment adjustments and favorable outcomes can be achieved through multidisciplinary collaboration.

Authors/Disclosures
Li Xiao PRESENTER	Mrs. Xiao has nothing to disclose.
Feiyan Wan	Dr. Wan has nothing to disclose.
Yin Wu, BS	Mrs. Wu has nothing to disclose.
Yuanyuan Tan, MD	Miss Tan has nothing to disclose.
Yuefei Guo, DO	Dr. Guo has nothing to disclose.
Yuge Wang (The Third Affiliated Hospital of Sun Yat-Sen University)	No disclosure on file
Wei Qiu, PhD	No disclosure on file

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