Ocrelizumab exposure in the second trimester of pregnancy without neonatal B-cell depletion

Mult Scler Relat Disord. 2020 Oct:45:102398. doi: 10.1016/j.msard.2020.102398. Epub 2020 Jul 14.

Abstract

Management of multiple sclerosis (MS) before and during pregnancy remains challenging given there are no disease-modifying therapies (DMTs) approved for use during pregnancy, and discontinuation of certain DMTs can lead to rebound relapses. Ocrelizumab is a highly effective therapy for relapsing-remitting MS (RRMS) without reported rebound after discontinuation. However, little is known about the safety of ocrelizumab before or during pregnancy. We report a case of second trimester ocrelizumab exposure in a patient with RRMS transitioning off natalizumab, that resulted in no neonatal B-cell depletion, no infections, and normal infant development, despite suppressed B-cells in the mother at delivery.

Keywords: B-cells; Disease-modifying therapy; Multiple sclerosis; Ocrelizumab; Pregnancy.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Antibodies, Monoclonal, Humanized / adverse effects
  • B-Lymphocytes
  • Child
  • Female
  • Humans
  • Infant, Newborn
  • Multiple Sclerosis, Relapsing-Remitting* / drug therapy
  • Pregnancy
  • Pregnancy Trimester, Second

Substances

  • Antibodies, Monoclonal, Humanized
  • ocrelizumab