CNS neuroscience & therapeutics
Efficacy and Safety of Multidisciplinary Sandwich Regimen in AQP4-IgG+ NMOSD With Preconception B-Cell Depletion During Perigravidity
By Xiao L, Lu G, Gao Q and 15 others.
Abstract
Background
Neuromyelitis optica spectrum disorder (NMOSD) predominantly affects women of childbearing age, accompanied by markedly elevated relapse risks during pregnancy and postpartum periods, bringing great challenges to perigravid management. At present, there is no standardized gestational therapeutic regimen for NMOSD worldwide, and data on perigravid application of B-cell depleting agents including rituximab and inebilizumab remain limited. For patients exposed to B-cell depleting agents before conception, balancing disease control and fetal safety is an urgent clinical problem to be solved.
Objective
This multicenter prospective cohort study aimed to evaluate the efficacy and safety of a three-stage multidisciplinary "sandwich" management regimen in AQP4-IgG-positive pregnant women with NMOSD exposed to B-cell depleting agents before conception. Maternal disease activity, pregnancy outcomes, neonatal conditions, and offspring growth and developmental characteristics within the first year of life were analyzed.