Pregnancy Outcomes in Women with Multiple Sclerosis Who Had Exposure to Ocrelizumab: a Systematic Review of the Literature.

Objective: To estimate the pooled prevalence of pregnancy-related issues in women who were exposed to Ocrelizumab before or during pregnancy.

Methods: PubMed, Scopus, EMBASE, Web of Science, Google Scholar, references and conference abstracts were comprehensively searched by two independent researchers. The search was conducted on 1 June 2023.

Results: A literature search revealed 320 records, of which 44 full-texts were evaluated and only five studies remained for the systematic review, among which one study was conducted in Australia, one in the United States, one in Canada and one in the United Kingdom. All eligible studies were conducted between 2017 and 2022. They included a number of patients ranging from 12 to 608, and totalized 1 305 participants and 1 306 pregnancies. The pooled prevalence of term delivery was 46% (95% CI 31-61%) (I²=94.5%, P<0.001). The pooled prevalence of abortion was 9% (95% CI 4-14%) (I²=80%, P<0.001). Three studies reported on the number of ectopic pregnancies. The pooled prevalence of ectopic pregnancies was 5% (95% CI 2-4%) (I²=60%, P<0.001). The pooled prevalence of major congenital malformations was 2% (95% CI 1-3%) (I²=0).

Conclusions: The results of this systematic review show that exposure to Ocrelizumab during conception is not associated with a higher frequency of preterm deliveries or major malformations.