Ocrelizumab exposure in the second trimester of pregnancy without neonatal B-cell depletion
Mary Rolfes1, Alice Rutatangwa2, Emmanuelle Waubant2
1Department of Pediatrics, University of California San Francisco, 550 16th Street, San Francisco CA 94158, United States.
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.
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