Evidence map›Paper›PMID 29564373›Full record

ArticleNeurology(R) neuroimmunology & neuroinflammation2018

Rituximab before and during pregnancy: A systematic review, and a case series in MS and NMOSD.

Gitanjali Das, Vincent Damotte, Jeffrey M Gelfand, Carolyn Bevan, Bruce A C Cree, Lynn Do, Ari J Green, Stephen L Hauser, Riley Bove

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology(R) neuroimmunology & neuroinflammation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 96 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
96citing papers in PubMed, 5 pooled it
10.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

96 citing papers in PubMed, 5 syntheses or guidelines pooled it, 207 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Rituximab for people with multiple sclerosis.The Cochrane database of systematic reviews · 2025
    Pooled it
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  5. Rituximab for people with multiple sclerosis.The Cochrane database of systematic reviews · 2021
    Pooled it
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36 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Gitanjali DasDepartment of Neurology, Weill Institute for the Neurosciences, University of California, San Francisco.
Vincent DamotteDepartment of Neurology, Weill Institute for the Neurosciences, University of California, San Francisco.
Jeffrey M GelfandDepartment of Neurology, Weill Institute for the Neurosciences, University of California, San Francisco.
Carolyn BevanDepartment of Neurology, Weill Institute for the Neurosciences, University of California, San Francisco.
Bruce A C CreeDepartment of Neurology, Weill Institute for the Neurosciences, University of California, San Francisco.
Lynn DoDepartment of Neurology, Weill Institute for the Neurosciences, University of California, San Francisco.
Ari J GreenDepartment of Neurology, Weill Institute for the Neurosciences, University of California, San Francisco.
Stephen L HauserDepartment of Neurology, Weill Institute for the Neurosciences, University of California, San Francisco.
Riley BoveDepartment of Neurology, Weill Institute for the Neurosciences, University of California, San Francisco.
University of California, San Francisco · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the safety of rituximab treatment before and during pregnancy in women with MS and neuromyelitis optica spectrum disorders (NMOSDs) who may be at risk of relapses by performing a systematic literature review combined with a retrospective single-center case series.

methodsStudies were systematically identified in the PubMed, Google Scholar, and EMBASE using the key terms "pregnancy" and "rituximab"; 22 articles were included for review (>17,000 screened). Then, patients with MS and NMOSD from 1 center (University of California, San Francisco) exposed to rituximab before conception were identified through medical record review.

resultsSystematic review: We identified 102 pregnancies with rituximab use within 6 months of conception: 78 resulted in live births and 12 in spontaneous abortions. Of 54 live births with reported gestational age, 31 occurred at term (37 weeks+) and 2 before 32 weeks. When checked, B-cell counts were low in 39% of newborns and normalized within 6 months. Case series: we identified 11 pregnancies (1 ongoing) in 10 women (7 MS and 3 NMOSD) treated with rituximab within 6 months of conception. All completed pregnancies resulted in term live births of healthy newborns (1 lost to follow-up at term). No maternal relapses occurred before/during pregnancy; 1 occurred postpartum (NMOSD).

conclusionNo major safety signal was observed with rituximab use within 6 months of conception. Beyond the need for monitoring neonatal B cells, these observations support prospectively monitoring a larger patient cohort to determine whether rituximab may safely protect women with MS and NMOSD who are planning a pregnancy against relapses.

Identifiers

PMID29564373
PMCPMC5858951
OpenAlexW2792505836

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.