ArticleNeurology(R) neuroimmunology & neuroinflammation2020
Rituximab, MS, and pregnancy.
Article in Neurology(R) neuroimmunology & neuroinflammation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06711354 (B-cell Depletion in Offspring to Women With MS and Rituximab Treatment Before or During Pregnancy), which is not on this map. Cited by 38 papers, 5 of them syntheses that pooled 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.
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.
B-cell Depletion in Offspring to Women With MS and Rituximab Treatment Before or During Pregnancy
Who cites it
38 citing papers in PubMed, 5 syntheses or guidelines pooled it, 91 citations in OpenAlex.
- Monoclonal antibodies in neuromyelitis optica spectrum disorder: a systematic review and meta-analysis.BMC neurology · 2026Pooled it
- Rituximab for people with multiple sclerosis.The Cochrane database of systematic reviews · 2025Pooled it
- Hypogammaglobulinemia and infections in patients with multiple sclerosis treated with anti-CD20 treatments: a systematic review and meta-analysis of 19,139 multiple sclerosis patients.Frontiers in neurology · 2024Pooled it
- British Society for Rheumatology guideline on prescribing drugs in pregnancy and breastfeeding: immunomodulatory anti-rheumatic drugs and corticosteroids.Rheumatology (Oxford, England) · 2023Guideline
- Rituximab for people with multiple sclerosis.The Cochrane database of systematic reviews · 2021Pooled it
- Pregnancy Exposure to Anti-CD20 Monoclonal Antibodies in Patients With Multiple Sclerosis: Results From an Italian Multicenter Registry Study.Neurology(R) neuroimmunology & neuroinflammation · 2026Observational
- The Treatment of Antibody-Mediated Encephalitis: Current, Future Therapies, Unmet Need and Patient Management.Advances in therapy · 2026Review
- Comparative Effectiveness of Rituximab Dosed Every 6 and 12 Months in Relapsing Multiple Sclerosis.Neurology · 2026Article
- Unexpected pregnancy in a patient with AQP4-IgG + NMOSD after treatment with inebilizumab: a case report.BMC neurology · 2026Article
- Disease Course, Outcomes, and Complications in Pregnant and Breastfeeding Women with Multiple Sclerosis Treated with Rituximab or Ocrelizumab: A Narrative Review.Journal of research in pharmacy practice · 2026Review
- Treatment of nephrotic syndrome with anti-CD20 therapies in pregnancy: a case series and review of the literature.Renal failure · 2025Review
- Pregnancy Outcomes in Women with Multiple Sclerosis Who Had Exposure to Rituximab: a Systematic Review and Meta-Analysis.Maedica · 2025Review
- Ten Years ofNeurology(R) neuroimmunology & neuroinflammation · 2025Article
- Impact of disease-modifying therapies on pregnancy outcomes in multiple sclerosis: a prospective cohort study from the German multiple sclerosis and pregnancy registry.The Lancet regional health. Europe · 2025Article
- Pregnancy and Infant Outcomes in Women With Multiple Sclerosis Treated With Ocrelizumab.Neurology(R) neuroimmunology & neuroinflammation · 2025Article
- Disease Activity in Pregnant and Postpartum Women With Multiple Sclerosis Receiving Ocrelizumab or Other Disease-Modifying Therapies.Neurology(R) neuroimmunology & neuroinflammation · 2024Article
- B-cell Depletion Therapy in Pediatric Neuroinflammatory Disease.Current neurology and neuroscience reports · 2024Review
- AT1-AA Is Produced in Offspring in Response to Placental Ischemia and Is Lowered by B-Cell Depletion Without Compromising Overall Offspring Health.Journal of the American Heart Association · 2024Article
- Rituximab and pregnancy: Late-onset neutropenia in a 2-month infant whose mother received rituximab 2 weeks prior to childbirth.Multiple sclerosis (Houndmills, Basingstoke, England) · 2024Article
- Exposure to medication for neurological disease in pregnancy - time to consider the long-term implications?EClinicalMedicine · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo describe the safety and efficacy of rituximab (RTX) in MS and pregnancy, we conducted a retrospective cohort study of 74 pregnancies among 55 women treated with RTX for MS and their offspring.
methodsWe used prospectively collected information from the electronic health record at Kaiser Permanente Southern California between 2012 and 2019 of mother and baby to identify treatment history, pregnancy outcomes, and relapses.
resultsLast RTX exposure before conception occurred between 1.8 and 5.2 months in 32 (49%) of 65 pregnancies and accidentally during the first trimester in 9 (12%). Among 38 live births, adverse pregnancy outcomes were as follows: 3 preterm deliveries (including 1 set of twins), 1 neonatal death (preterm twin), and 1 perinatal stroke (full-term). No stillbirths, chorioamnionitis, or major malformations were found. Fifteen (27%) women had at least one first-trimester miscarriage, of whom 8 (53%) had a history of infertility. Cumulative dose or timing of last RTX infusion was not associated with an increased risk of miscarriage. Only 2 (5.4%) women experienced relapses, one during pregnancy and the other postpartum.
conclusionWe observed no increase in adverse pregnancy outcomes compared with expected national incidence rates and remarkably little disease activity in RTX-treated women with MS, particularly when compared with periconceptional natalizumab-treated cohorts. However, larger studies are needed to fully assess the safety of RTX use before pregnancy, especially risks associated with prolonged B-cell depletion and hypogammaglobulinemia. Until these data are available, we recommend restricting RTX use before pregnancy to women who require highly effective MS treatments. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that for pregnant women with MS, RTX controls disease activity and does not increase adverse pregnancy outcomes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.