CClinicalTrials.gg
Not yet recruitingNCT07149662Updated Nov 25, 2025

Immune System Effects in Children Born to Women With Multiple Sclerosis Treated With Monoclonal Antibody Therapy During Pregnancy

An observational study in Multiple Sclerosis and Pregnancy, sponsored by Region Stockholm. Not yet recruiting at 1 site in Sweden. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-11-25.

Sponsored by Region Stockholm · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
111
Ages
18 Years and older
Sex
Female
01

Study summary

The goal of this observational study is to learn about consequences for the child when the mother is treated with rituximab (or other monoclonal CD-20 antibodies) before or during pregnancy. The main questions it aims to answer are:

  • Is the infant's immune system effected with lower levels of B-cell markers, higher rates of infections or poor vaccine response?
  • Are the monoclonal CD20-antibodies fully eliminated in women treated within 6 (12) months prior to conception?

Participants will:

  • At the time of clinical routine blood sampling (at the end of each trimester) the becoming mother will give some additional blood samples for analysis of drug concentration
  • Within the first year postpartum the child will leave a blood sample to detect antibodies induced by vaccination or infections
  • Within our routine contacts with the participant (mother) will be asked about infections in both the mother and the child
Read the detailed description

In offspring to women with MS and current pregnancies the investigators will address if a reduction in the levels of KREC (kappa-deleting recombination excision circles) and/or CD19+ B-cells at birth has clinical significance. Participants with MS regardless of treatment that have successfully delivered or will deliver a child will be asked for informed consent and after given informed consent they will be included in the study.

  1. At the time of clinical routine sampling in the becoming mother the investigators will collect additional blood samples. Routine analysis collects information on immunoglobulin levels and b-cell levels, additional blood samples will allow analysis of drug concentration at the end of every trimester.
  2. Within the first year postpartum, but earliest one month after vaccination, the investigators will ask for a blood sample from the child to detect antibodies induced by vaccination or infections to secure the ability to develop antibodies despite being exposed to monoclonal CD20-antibodies in-utero or via breastmilk. All children followed by the Specialist outpatient clinic for children in Liljeholmen - a specialist clinic from the Karolinska University Hospital following children to mothers on immunosuppressant/immunomodulating treatments regardless of disease, will be offered blood sampling by routine months 2, 6 and 1 year postpartum. In collaboration with this center, the investigators will get samples taken and analyzed within clinical routine.
  3. PKU-test is taken in the child within routine but additional analysis on drug levels and KREC will be analyzed as well as determining abundance of CD19 transcripts.
  4. Within the routine contacts with the MS patient (mother) the investigators will ask for infections in both, the mother and the child at 3 months and 1 year post-partum.
02

Conditions studied

  • Multiple Sclerosis
  • Pregnancy

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Keywords

  • Multiple Sclerosis
  • Rituximab
  • Ocrelizumab
  • Ofatumumab
  • monoclonal CD-20 antibodies
  • Pregnancy
03

In context

Multiple Sclerosis

3,460 studies on the registry are indexed under Multiple Sclerosis; 661 are open to participants now.

This study's planned enrollment of 111 is above the median of 100 across 1,016 observational studies indexed under Multiple Sclerosis.

Browse Multiple Sclerosis studies →

Lead sponsor

Region Stockholm is the lead sponsor of 119 studies on the registry; 70 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Women diagnosed with multiple sclerosis that are patients at the Academic specialist center, Center for Neurology, Stockholm, Sweden

Inclusion criteria

  • Established multiple sclerosis diagnosis
  • Rituximab, ocrelizumab, ofatumumab or other monoclonal CD-20 antibody has been administered within 6 (12) months prior to or during pregnancy
  • Other immun modulation treatment has been administered within 6 (12) months prior to or during pregnancy
  • No treatment has been administered within 6 (12) months prior to or during pregnancy

Exclusion criteria

Exclusion Criteria:

- Previous stem cell transplantation

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
111 participants (estimated)
Patient registry
No

Groups and cohorts

  • Women with MS during pregnancy

    Women over 18 years of age with the diagnosis of multiple sclerosis, regardless of treatment, or no treatment, that have successfully delivered or will deliver a child

    Drug: monoclonal CD-20 antibodies · Drug: No Drug · Drug: Other treatment

  • Infants born to women with MS

    Infants born to women with multiple sclerosis

    Drug: monoclonal CD-20 antibodies · Drug: No Drug · Drug: Other treatment

Interventions

  • Drugmonoclonal CD-20 antibodies

    Treatment with monoclonal CD-20 antibodies 6 months before or during pregnancy

    Also known as: rituximab, ocrelizumab, ofatumumab

  • DrugNo Drug

    No medication

  • DrugOther treatment

    Any other immune modulating treatment

06

What researchers measure

Primary outcomes

  1. Effect on infant immune system

    Levels of KREC (copies/micro L) at birth.

    Time frame: At birth

  2. Effect on infant immune system

    CD19+ B-cell (nx10\^9 cells/L) levels at birth

    Time frame: At birth

  3. Effect on infant immune system

    Infant levels of antibodies (g/L) induced by vaccination or infections

    Time frame: Age 2 months - 1 year

  4. Effect on infant immune system

    Infection during first year of life (n/12 months)

    Time frame: Age 1 year

Secondary outcomes

  1. Drug level concentration infant

    Drug level concentration (microgram/ml) measured from dried blood spots (PKU-test)

    Time frame: At birth - 3 days old

Other outcomes

  1. Effects on mother´s immune system

    Immunoglobulin (g/L) levels

    Time frame: From enrollment to three months after birth

  2. Effects on mother´s immune system

    B-cell levels nx10\^9/L

    Time frame: From enrollment to three months after birth

  3. Effects on mother´s immune system

    Drug concentration (microgram/ml)

    Time frame: From enrollment to three months after birth

07

Study locations

1 site
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References and documents

Individual participant data

Plan to share: Yes — We plan to share all pseudoanonymised IPD that underlie results in a future publication.

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 25, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07149662
Lead sponsor
Region Stockholm
Collaborators
The Swedish Research Council, Haukeland University Hospital, Karolinska Institutet
Responsible party
Katharina Fink (MD, Dr. med., Region Stockholm) — Principal investigator
First posted
Sep 2, 2025
Start date
Feb 2026 (estimated)
Primary completion
Oct 2027 (estimated)
Completion
Mar 2028 (estimated)
Last update
Nov 25, 2025

Study contacts

Katharina Fink, MD, Dr. med.
Contact
Katharina.fink@regionstockholm.se
+46706571789
Greta Mirzaoff, MD
Contact
greta.lundborg-mirzaoff@regionstockholm.se
08-123 400 00
Katharina Fink, MD, Dr. med.
study director · Karolinska Institutet

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Aug 2025. You cannot join it, but the record below documents what was studied.

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