ArticleAnnals of clinical and translational neurology2023
Anti-CD20 monoclonal antibody therapy in postpartum women with neurological conditions.
Article in Annals of clinical and translational neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06940323 (Pregnancy Registry, Infants, Serum/Milk Analysis), which is not on this map. Cited by 16 papers, 1 of them a synthesis 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.
Pregnancy Registry, Infants, Serum/Milk Analysis (PRISMA): Pregnancy Registry for Women With Chronic Conditions
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Maternal disease control and pregnancy outcomes with anti-CD20 therapy versus natalizumab in multiple sclerosis: a systematic review.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Pooled it
- UK consensus on pregnancy in multiple sclerosis: An update to 'Association of British Neurologists' guidance.Multiple sclerosis (Houndmills, Basingstoke, England) · 2026Review
- Bruton's Tyrosine Kinase Inhibitors in Multiple Sclerosis: Mechanistic Considerations Across Relapsing and Progressive Disease.Molecules (Basel, Switzerland) · 2026Review
- Multiple Sclerosis in Women: Impact of Different Life Stages on Treatment Decisions.CNS drugs · 2026Review
- 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
- Four years on: Pregnancy and birth outcomes reported in the MSBase pregnancy, neonatal outcomes, and Women's Health Registry (2020-2024).Multiple sclerosis (Houndmills, Basingstoke, England) · 2025Article
- Treatment Strategies and Disease Activity During Pregnancy and Postpartum: Real-World Data From the Swiss Multiple Sclerosis Cohort.Neurology. Clinical practice · 2025Article
- Safety of Drugs in Breastfeeding Women With CKD.Kidney international reports · 2025Article
- Impact of Continuous Ofatumumab Exposure During Pregnancy in Multiple Sclerosis.Neurology. Clinical practice · 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
- Topical review: Lactation and use of DMTs in women with MS.Multiple sclerosis (Houndmills, Basingstoke, England) · 2024Review
- Patient-centered pregnancy planning in multiple sclerosis: evidence for a new era.Arquivos de neuro-psiquiatria · 2024Review
- Post-Partum Clinical and Patient-Reported Outcome Changes in Mothers with Multiple Sclerosis: Findings from the NAPPREMS Study.Medicina (Kaunas, Lithuania) · 2024Article
- [XVI Post-ECTRIMS Meeting: review of the new developments presented at the 2023 ECTRIMS Congress (II)].Revista de neurologia · 2024Article
- Absence of significant hematologic abnormalities in breastfed infants of mothers with multiple sclerosis treated with anti-CD20 therapies.Multiple sclerosis journal - experimental, translational and clinicalArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
23 authors at 15 institutions in 4 countries.
Funding
Abstract
objectivePostpartum, patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) have increased risk for disease activity. Anti-CD20 IgG1 monoclonal antibodies (mAb) are increasingly used as disease-modifying therapies (DMTs). Patients may wish to both breastfeed and resume DMT postpartum. This study aimed to determine the transfer of anti-CD20 IgG1 mAbs, ocrelizumab, and rituximab (OCR/RTX), into mature breastmilk and describe maternal and infant outcomes.
methodsFifty-seven cis-women receiving OCR/RTX after 59 pregnancies and their infants were enrolled and followed up to 12M postpartum or 90 days post-infusion. Breastmilk was collected pre-infusion and serially up to 90 days and assayed for mAb concentration. Medical records and patients' questionnaire responses were obtained to assess neurologic, breastfeeding, and infant development outcomes.
resultsThe median average concentration of mAb in breastmilk was low (OCR: 0.08 μg/mL, range 0.05-0.4; RTX: 0.03 μg/mL, range 0.005-0.3). Concentration peaked 1-7 days post-infusion in most (77%) and was nearly undetectable after 90 days. Median average relative infant dose was <1% (OCR: 0.1%, range 0.07-0.7; RTX: 0.04%, range 0.005-0.3). Forty-three participants continued to breastfeed post-infusion. At 8-12 months, the proportion of infants' growth between the 3rd and 97th World Health Organization percentiles did not differ for breastfed (36/40) and non-breastfed (14/16, p > 0.05) infants; neither did the proportion with normal development (breastfed: 37/41, non-breastfed: 11/13; p > 0.05). After postpartum infusion, two mothers experienced a clinical relapse.
interpretationThese confirm minimal transfer of mAb into breastmilk. Anti-CD20 mAb therapy stabilizes MS activity before conception to the postpartum period, and postpartum treatments appears to be safe and well-tolerated for both mother and infant.
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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.