Rituximab for treatment of refractory multiple sclerosis relapses during pregnancy

Area of Science:

• Neurology
• Immunology
• Reproductive Medicine

Background:

• Multiple sclerosis (MS) activity typically decreases during pregnancy.
• However, MS relapses can still occur in pregnant individuals.
• Severe or refractory relapses may necessitate aggressive treatment options.

Purpose of the Study:

• To describe the use of rituximab for severe, refractory multiple sclerosis relapses during pregnancy.
• To evaluate the safety and efficacy of rituximab in this specific patient population.

Main Methods:

• Retrospective case series describing two pregnant women with severe, refractory multiple sclerosis relapses.
• Treatment with rituximab was administered.
• Pregnancy outcomes and subsequent MS disease activity were monitored.

Main Results:

• Rituximab treatment did not appear to complicate either pregnancy.
• No further MS relapses were observed in either patient post-treatment.
• This suggests potential efficacy in managing severe, refractory MS during gestation.

Conclusions:

• Rituximab can be a viable option for managing rare, severe, and refractory multiple sclerosis relapses in pregnant women.
• It should be considered, especially in cases of rebound relapses after discontinuing other therapies.
• Further research is warranted to confirm safety and efficacy in larger cohorts.