Maternal disease control and pregnancy outcomes with anti-CD20 therapy versus natalizumab in multiple sclerosis: a systematic review.
Abdulaziz Altamimi, Bashayr Arif Almutairi, Mohammed Essam Shaybah et al.
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In 30 seconds
This systematic review evaluated the effectiveness and safety of anti-CD20 therapy versus natalizumab in pregnant women with multiple sclerosis. The analysis of seven studies indicated that anti-CD20 exposure was associated with lower relapse activity and postpartum MRI activity compared to natalizumab, with a relative risk of 0.06 for postpartum MRI activity. However, fetal safety data remain limited.
Key findings
- Anti-CD20 therapy was linked to lower relapse activity compared to natalizumab during pregnancy.
- Postpartum MRI activity was significantly reduced with anti-CD20 therapy (RR 0.06, 95% CI 0.02-0.24).
- Some data suggested higher odds of small for gestational age with anti-CD20 exposure.
Why it matters
Understanding the comparative effectiveness of disease-modifying therapies during pregnancy is crucial for optimizing maternal health while ensuring fetal safety. This review provides insights that may guide treatment decisions in pregnant women with multiple sclerosis.