Continuing Tysabri (natalizumab) treatment up to week 28 of pregnancy, and restarting soon after birth, reduces the risk of relapses in women with multiple sclerosis and appears to be safe for the mother and the baby, new research suggests.
Doriana Landi, MD, PhD, from Italy’s University of Rome Tor Vergata, presented the findings at the 35th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), held Sept. 11–13 in Stockholm, Sweden.
What therapy to choose, and for how long to take it, have been emerging issues for women with MS who are pregnant or planning to become pregnant.
“We all know that not all treatments are compatible with pregnancy planning, especially second-line treatments which are usually used for highly active MS women,” Landi said.
One problem is the lack of data that can elucidate the risks, and guide therapy choices before, during, and after pregnancy. In particular, there is a lack on information “on how to manage our highly active patients,” such as those treated with Tysabri (marketed by Biogen), Landi added.
Suspension of Tysabri treatment is currently discouraged in patients planning pregnancy, due to concerns of disease reactivation or worsening — patients may become exposed to a higher risk of relapses, Landi said.
A 2018 study showed that “suspending natalizumab treatment before conception was associated with a higher risk of disease relapses during pregnancy,” Landi said, while “receiving the last natalizumab infusion after the onset of the last menstrual period led to an approximately 3-fold reduction of the risk of relapses during pregnancy.”
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