Critical Aspects of Treatment During Postpartum in Patients with MS, NMOSD: Riley Bove, MD

WATCH TIME: 4 minutes

“I'd say that the physiology, the biology of pregnancy, in general, is fascinating and sort of how this impacts the immunological condition is fascinating as well. I'm really looking forward to see more science evolve as we understand how that physiology of pregnancy influences the physiology of multiple sclerosis.”

At the 2022 European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress, from October 26-28, in Amsterdam, Netherlands, an oral presentation was presented on postpartum use of anti-CD20 monoclonal antibody (mAb) therapies in patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD).¹ The study showed that this type of therapy, which included ocrelizumab (Ocrevus; Genentech) and rituximab (Rituxan; Genentech), was safe and well-tolerated for both mothers and infants during lactation. The outcomes were assessed over the course of 12 months post delivery in 57 women with MS or NMOSD between November 2017 and July 2021 from 12 MS Centers in Germany and the US.

Coauthor Riley Bove, MD, associate professor of neurology, University of California, San Francisco, and colleagues gave the women 1-2 doses of ocrelizumab300 or 600mg, or rituximab 500 or 1000mg, during breastfeeding. Results showed that the median average concentration of mAb was low at 0.18μg/mL (ocrelizumab, n=32) and 0.04μg/mL (rituximab, n=21) in breastmilk. The average median dosage for infants was 0.16% for ocrelizumab and 0.04% for rituximab. 

In a recent interview with NeurologyLive^®, Bove mentioned the key advances in understanding how to navigate the postpartum period for patients with MS. Looking forward, she also spoke about the types of data she would like to see conducted outside of the postpartum period.

Click here for more coverage of ECTRIMS 2022.

REFERENCES
 1. Anderson A, Poole S, Rowles W et al. Anti-CD20 monoclonal antibody therapy after 59 pregnancies in women with neurological conditions: low breastmilk transfer and normal infant development in a multicenter cohort. Presented at: 2022 ECTRIMS Congress; October 26-28; Amsterdam, Netherlands. Abstract 0037