Key clinical point: At 1 year postpartum, clinically meaningful disability from pregnancy-related multiple sclerosis (MS) relapses after natalizumab cessation was retained by over 10% of patients with neither restarting natalizumab shortly after delivery nor solely breastfeeding the infant, providing protection against relapse.
Major finding: Overall, 10.58% of pregnancies accrued significant relapse-related disability at 1 year postpartum . Exclusive breastfeeding (adjusted hazard ratio [aHR] 1.34; 95% CI 0.86-2.10 ) or restarting natalizumab within 4 weeks postpartum (aHR 1.06; 95% CI 0.48-2.36) was not linked to a lower risk for early postpartum relapses 6 months after delivery.
Study details: The findings come from a prospective cohort study that evaluated 274 successful pregnancies in 255 women with MS from the German MS and Pregnancy Registry. The patients stopped natalizumab before pregnancy or in the first trimester.
Disclosures: The registry was partly supported by the German Federal Joint Committee's Innovation Fund and various pharmaceutical companies. Some authors reported receiving speaker fees, honoraria, research support, and travel grants from or serving on advisory boards for various sources.
Source: Hellwig K et al. JAMA Netw Open. 2022;5(1):e2144750 (Jan 24). Doi: 10.1001/jamanetworkopen.2021.44750