Neurol. praxi. 2025;26(6):498-504 | DOI: 10.36290/neu.2025.081

Ocrelizumab and treatment of multiple sclerosis during pregnancy and breastfeeding

MUDr. Jana Pavlíčková, Ph.D.

Neurologická klinika 1. LF UK a VFN, Praha

Multiple sclerosis is an autoimmune neurological disease that is very often diagnosed in women of childbearing age. Multiple sclerosis does not worsen the course of pregnancy; the risk of relapse is low during pregnancy, but increases after delivery. A key factor in the treatment of our patients is therefore pregnancy planning and therapy that stabilizes patients during pregnancy and postpartum and does not pose a risk to the fetus or newborn. Ocrelizumab (humanized anti-CD20 monoclonal antibody) administered before planned pregnancy and during lactation shows minimal transfer through the placental barrier and into breast milk, allowing according to recent studies for its safe use in women planning to become pregnant. In this article, we present two case reports of patients treated with highly effective therapy ocrelizumab before pregnancy and after delivery.

Keywords: multiple sclerosis, pregnancy, breastfeeding (lactation), ocrelizumab.

Received: September 19, 2025; Revised: November 19, 2025; Accepted: November 19, 2025; Prepublished online: November 19, 2025; Published: December 15, 2025  Show citation