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EAN 2022 | Natalizumab concentrations during pregnancy in MS patients

Alyssa Toorop, MD, PhD, Amsterdam University Medical Center, Amsterdam, The Netherlands, discusses the use of natalizumab during pregnancy in patients with multiple sclerosis (MS). In women with very active disease, natalizumab can be continued during pregnancy to prevent rebound disease activity. Usually, patients are treated with extended interval dosing (EID) to minimize fetal exposure to natalizumab since patients with EID usually have lower trough concentrations of natalizumab compared with patients with standard interval dosing. A study evaluating changes in natalizumab trough concentrations during pregnancy in patients with relapsing-remitting MS was conducted to assess the possible influence of pregnancy on natalizumab pharmacokinetics. Natalizumab trough concentrations were measured before, during, and after pregnancy in blood samples of three patients. A gradual decrease in natalizumab trough concentrations was observed during pregnancy, and the patient with the lowest drug level was treated with EID. After delivery, drug concentrations increased to similar levels as before pregnancy, and all patients remained clinically and radiologically stable. This interview took place at the European Academy of Neurology (EAN) 2022 Congress in Vienna, Austria.