Natalizumab discontinuation and disease restart in pregnancy: a case series

Acta Neurol Scand. 2015 May;131(5):336-40. doi: 10.1111/ane.12364. Epub 2015 Jan 18.


Background: The humanized monoclonal alpha4-integrin antibody Natalizumab (NTZ) (Tysabri(©) , Biogen Idec, Cambridge, MA, USA) has shown to be effective in multiple sclerosis (MS) therapy; however, the interruption of the drug has been related to a disease restart. This risk has to be carefully considered in case of accidental or desired pregnancies.

Aim of the study: To report the risk of disease restart in patients who interrupted NTZ because of pregnancy and discuss the implication of NTZ choice in female childbearing patients with MS.

Methods: Clinical histories and MRI images of four pregnant women with MS who interrupted NTZ.

Results: Despite pregnancy is usually related with disease stability, the cases presented here showed an abrupt increase of disability with high number of MRI lesions, some of them with a mass effect.

Conclusions: We recommend that female patients on childbearing age must be informed before starting NTZ treatment of the risk of a return of disease activity when the drug is discontinued. The risk occurs even during pregnancy a condition that is considered as protective for women with MS.

Keywords: Multiple sclerosis; Natalizumab; Pregnancy.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Humanized / administration & dosage*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Multiple Sclerosis / drug therapy*
  • Natalizumab
  • Pregnancy Complications / drug therapy*
  • Pregnancy* / drug effects
  • Recurrence


  • Antibodies, Monoclonal, Humanized
  • Natalizumab