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Master Thesis

Exposition au Natalizumab au cours de la grossesse dans la sclérose en plaques rémittente récurrente

Abstract : Introduction: pregnancy management in patients with relapsing remitting multiple sclerosis treated by Natalizumab (NTZ) is challenging because of the risk of disease reactivation after treatment discontinuation and the lack of data concerning antenatal exposure to NTZ. Objectives of this work were to describe maternal and fetal adverse effects due to NTZ exposure during pregnancy and to compare clinical disease activity during and after pregnancy according to three therapeutic approaches regarding NTZ. Methods: first, we conducted a monocentric retrospective study. For the patients who started a pregnancy while taking NTZ, we describe the course of their pregnancies and the health condition of their newborns. Then, we conducted a multicentric study « BABYZUMAB 1 » based on a nationwide MS registry named OFSEP. We included patients who started a pregnancy while taking Natalizumab or within six months after its suspension. Three groups were compared according to therapeutic strategy: continuation of NTZ throughout pregnancy and postpartum (group 1), continuation until 3 to 6 months of pregnancy (group 2) and suspension prior to pregnancy (group 3). We analyzed the annual relapse rate (ARR) during a two-year period around pregnancy and effects on EDSS and MRI. Results: 24 pregnancies were described at Bordeaux’s Hospital Center. Among the 21 newborns, anemia and thrombocytopenia were observed after third trimester exposure. In BABYZUMAB 1 study, 117 patients from 27 centers were included. The ARR was higher in groups 2 and 3 than in group 1 (p=0.007). Conclusion: results of BABYZUMAB 1 support continuation of NTZ during all three trimesters of pregnancy considering the risk of relapses. Our local data seem reassuring with mainly hematological neonatal risks which are non serious at short term and transient.
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Submitted on : Wednesday, December 9, 2020 - 1:49:16 PM
Last modification on : Tuesday, January 26, 2021 - 3:10:16 AM
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  • HAL Id : dumas-03048534, version 1




Pauline Bouchard. Exposition au Natalizumab au cours de la grossesse dans la sclérose en plaques rémittente récurrente. Sciences du Vivant [q-bio]. 2020. ⟨dumas-03048534⟩



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