Natalizumab treatment during pregnancy in multiple sclerosis-clinical and bioethical aspects of an ongoing debate

Abstract

Background: Natalizumab is an approved treatment for relapsing remitting multiple sclerosis; however, its safety during pregnancy is not formally proven.

Case presentation: We report a woman with multiple sclerosis being treated with natalizumab before pregnancy. After withdrawal of natalizumab, she suffered a severe, disabling rebound. In agreement with the patient, natalizumab was restarted during pregnancy. Our patient improved substantially and gave birth to a healthy boy.

Conclusion: Use of natalizumab during pregnancy may be an option in highly active multiple sclerosis.

Keywords: Bioethics; Decision-making; Disease-modifying treatment; MS; Safety.