Natalizumab concentrations during pregnancy in three patients with multiple sclerosis

Alyssa A. Toorop; Theo Rispens; Eva M. M. Strijbis; Bob W. van Oosten; Brigit A. de Jong; Bernard M. J. Uitdehaag; Joep Killestein; Zoé L. E. van Kempen

doi:https://doi.org/10.1177/13524585211052168

Natalizumab concentrations during pregnancy in three patients with multiple sclerosis

Alyssa A. Toorop, Theo Rispens, Eva M. M. Strijbis, Bob W. van Oosten, Brigit A. de Jong, Bernard M. J. Uitdehaag, Joep Killestein, Zoé L. E. van Kempen

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

In women with very active multiple sclerosis (MS), natalizumab can be continued during pregnancy to prevent rebound disease activity. Our aim was to evaluate changes in serum natalizumab trough concentrations during pregnancy. Blood samples of 3 patients were collected before, during, and after pregnancy. Natalizumab trough concentrations gradually decreased during pregnancy. The patient with the lowest trough concentrations during the third trimester was treated with extended interval dosing (EID). After delivery, natalizumab concentrations increased to similar levels as before pregnancy. All patients remained clinically and radiologically stable. MS neurologists should be aware of decreasing natalizumab concentrations during pregnancy, especially in patients with low initial trough concentrations and patients with EID.

Original language	English
Journal	MULTIPLE SCLEROSIS JOURNAL
Early online date	2021
DOIs	https://doi.org/10.1177/13524585211052168
Publication status	E-pub ahead of print - 2021

Keywords

Multiple sclerosis
concentrations
extended interval dosing
natalizumab
personalized dosing
pregnancy

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https://doi.org/10.1177/13524585211052168

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title = "Natalizumab concentrations during pregnancy in three patients with multiple sclerosis",

abstract = "In women with very active multiple sclerosis (MS), natalizumab can be continued during pregnancy to prevent rebound disease activity. Our aim was to evaluate changes in serum natalizumab trough concentrations during pregnancy. Blood samples of 3 patients were collected before, during, and after pregnancy. Natalizumab trough concentrations gradually decreased during pregnancy. The patient with the lowest trough concentrations during the third trimester was treated with extended interval dosing (EID). After delivery, natalizumab concentrations increased to similar levels as before pregnancy. All patients remained clinically and radiologically stable. MS neurologists should be aware of decreasing natalizumab concentrations during pregnancy, especially in patients with low initial trough concentrations and patients with EID.",

keywords = "Multiple sclerosis, concentrations, extended interval dosing, natalizumab, personalized dosing, pregnancy",

author = "Toorop, {Alyssa A.} and Theo Rispens and Strijbis, {Eva M. M.} and {van Oosten}, {Bob W.} and {de Jong}, {Brigit A.} and Uitdehaag, {Bernard M. J.} and Joep Killestein and {van Kempen}, {Zo{\'e} L. E.}",

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year = "2021",

doi = "https://doi.org/10.1177/13524585211052168",

language = "English",

journal = "MULTIPLE SCLEROSIS JOURNAL",

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TY - JOUR

T1 - Natalizumab concentrations during pregnancy in three patients with multiple sclerosis

AU - Toorop, Alyssa A.

AU - Rispens, Theo

AU - Strijbis, Eva M. M.

AU - van Oosten, Bob W.

AU - de Jong, Brigit A.

AU - Uitdehaag, Bernard M. J.

AU - Killestein, Joep

AU - van Kempen, Zoé L. E.

N1 - Publisher Copyright: © The Author(s), 2021.

PY - 2021

Y1 - 2021

N2 - In women with very active multiple sclerosis (MS), natalizumab can be continued during pregnancy to prevent rebound disease activity. Our aim was to evaluate changes in serum natalizumab trough concentrations during pregnancy. Blood samples of 3 patients were collected before, during, and after pregnancy. Natalizumab trough concentrations gradually decreased during pregnancy. The patient with the lowest trough concentrations during the third trimester was treated with extended interval dosing (EID). After delivery, natalizumab concentrations increased to similar levels as before pregnancy. All patients remained clinically and radiologically stable. MS neurologists should be aware of decreasing natalizumab concentrations during pregnancy, especially in patients with low initial trough concentrations and patients with EID.

AB - In women with very active multiple sclerosis (MS), natalizumab can be continued during pregnancy to prevent rebound disease activity. Our aim was to evaluate changes in serum natalizumab trough concentrations during pregnancy. Blood samples of 3 patients were collected before, during, and after pregnancy. Natalizumab trough concentrations gradually decreased during pregnancy. The patient with the lowest trough concentrations during the third trimester was treated with extended interval dosing (EID). After delivery, natalizumab concentrations increased to similar levels as before pregnancy. All patients remained clinically and radiologically stable. MS neurologists should be aware of decreasing natalizumab concentrations during pregnancy, especially in patients with low initial trough concentrations and patients with EID.

KW - Multiple sclerosis

KW - concentrations

KW - extended interval dosing

KW - natalizumab

KW - personalized dosing

KW - pregnancy

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U2 - https://doi.org/10.1177/13524585211052168

DO - https://doi.org/10.1177/13524585211052168

M3 - Article

C2 - 34931887

SN - 1352-4585

JO - MULTIPLE SCLEROSIS JOURNAL

JF - MULTIPLE SCLEROSIS JOURNAL

ER -

Natalizumab concentrations during pregnancy in three patients with multiple sclerosis

Abstract

Keywords

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