006  Secondary amenorrhea related to natalizumab

BackgroundAdverse events are inevitable for many pharmacological interventions, including disease modifying treatment (DMT) in Multiple Sclerosis (MS). Amenorrhoea was reported in less than 2% in phase 3 trials of Natalizumab. Isolated cases have also been reported post marketing.We present a patien...

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Published inJournal of neurology, neurosurgery and psychiatry Vol. 93; no. 6; pp. A15 - A16
Main Authors Obeng, Laurenda, Brown, Heather, Wheately, Trevor, Good, Catriona, Fisniku, Leonora
Format Journal Article
LanguageEnglish
Published London BMJ Publishing Group Ltd 01.06.2022
BMJ Publishing Group LTD
Subjects
ABN Abstracts 2020
Amenorrhea
Blood-brain barrier
Brain
Hospitals
Inflammation
Magnetic resonance imaging
Medicine
Monoclonal antibodies
Multiple sclerosis
Neurosciences
Patients
Permeability
Proteins
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Summary:BackgroundAdverse events are inevitable for many pharmacological interventions, including disease modifying treatment (DMT) in Multiple Sclerosis (MS). Amenorrhoea was reported in less than 2% in phase 3 trials of Natalizumab. Isolated cases have also been reported post marketing.We present a patient who developed secondary amenorrhoea linked to Natalizumab treatment for her relapsing-remitting MS (RRMS).CaseA 36 year old female with highly-active RRMS was started on Natalizumab in June 2014. She developed secondary amenorrhoea by July 2014. Her blood results show low LH, normal FSH and low oestrogen and progesterone and normal thyroid function tests. She remained on Natalizumab for a year and her MS was stable. Due to continuing amenorrhoea Natalizumab was stopped and 3 months later she started menstruating regularly. Her hormonal changes were also normalised. Review of all her imaging from July 2014 – September 2016 revealed no evidence of a pituitary or hypothalamic abnormality or patho- logical enhancement. Patient was subsequently treated with Alemtuzumab and has remained stable.ConclusionWhereas a simple temporal association between a drug use and a particular event does not necessarily indicate a direct causal relationship, the occurrence of amenorrhoea in our patient linked to the start of Natalizumab and its resolution 3 months post treatment cessation, is too good of a coincidence to be fully dismissed.leonora.fisniku@nhs.net
Bibliography:Poster Presentations
ISSN:0022-3050
1468-330X
DOI:10.1136/jnnp-2022-ABN.45