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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">nnp</journal-id><journal-title-group><journal-title xml:lang="en">Neurology, Neuropsychiatry, Psychosomatics</journal-title><trans-title-group xml:lang="ru"><trans-title>Неврология, нейропсихиатрия, психосоматика</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2074-2711</issn><issn pub-type="epub">2310-1342</issn><publisher><publisher-name>"IMA-Press", LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.14412/2074-2711-2025-4-100-103</article-id><article-id custom-type="elpub" pub-id-type="custom">nnp-2667</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL OBSERVATIONS</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯ</subject></subj-group></article-categories><title-group><article-title>Pregnancy during therapy with teriflunomide. A clinical case of accelerated elimination of teriflunomide</article-title><trans-title-group xml:lang="ru"><trans-title>Беременность на фоне терапии	 терифлуномидом. Клинический случай ускоренной элиминации терифлуномида</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9540-1859</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Якушин</surname><given-names>Д. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Yakushin</surname><given-names>D. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>129110, Москва, ул. Щепкина, 61/2, корп. 10</p></bio><bio xml:lang="en"><p>61/2, Shchepkina St., Moscow 129110</p></bio><email xlink:type="simple">kotovsv@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8706-7317</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Котов</surname><given-names>С. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kotov</surname><given-names>S. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сергей Викторович Котов - Центр рассеянного склероза и других нейроиммунологических заболеваний.</p><p>129110, Москва, ул. Щепкина, 61/2, корп. 10</p></bio><bio xml:lang="en"><p>Sergey Viktorovich Kotov - Center for Multiple Sclerosis and Other Neuroimmunological Diseases.</p><p>61/2, Shchepkina St., Moscow 129110</p></bio><email xlink:type="simple">kotovsv@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Якушина</surname><given-names>Т. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Yakushina</surname><given-names>T. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>129110, Москва, ул. Щепкина, 61/2, корп. 10</p></bio><bio xml:lang="en"><p>61/2, Shchepkina St., Moscow 129110</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ГБУЗ МО «Московский областной научно-исследовательский клинический институт им. М.Ф. Владимирского»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>M.F. Vladimirsky Moscow Regional Research and Clinical Institute</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>23</day><month>08</month><year>2025</year></pub-date><volume>17</volume><issue>4</issue><fpage>100</fpage><lpage>103</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Yakushin D.M., Kotov S.V., Yakushina T.I., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Якушин Д.М., Котов С.В., Якушина Т.И.</copyright-holder><copyright-holder xml:lang="en">Yakushin D.M., Kotov S.V., Yakushina T.I.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://nnp.ima-press.net/nnp/article/view/2667">https://nnp.ima-press.net/nnp/article/view/2667</self-uri><abstract><p>Despite warnings about the need to use effective contraception during therapy with teriflunomide, a number of patients still plan to become pregnant or inform their doctor that they are already pregnant while taking the drug. According to the drug's instructions, in these cases, therapy should be stopped right away and a procedure should be done to quickly get the teriflunomide down to a safe level in the blood plasma – no more than 0.02 μg/ml. The drug colestyramine, recommended for this purpose, is not registered in Russia. The proposed alternative use of activated charcoal at 50 g every 12 hours for 11 days (400 tablets per day) is fraught with undesirable side effects in the form of constipation, diarrhoea, and impaired absorption of calcium, vitamins and other nutrients, which is unacceptable for pregnant women and may have a negative effect on the fetus. The question arises: what to do in such cases? We have demonstrated a clinical case of accelerated elimination of teriflunomide in a pregnant patient using the drug Polysorb MP. The use of this tactic made it possible to reduce the concentration of the drug in the blood by 50 times within 1 month: from 1.39 to 0.028 μg/ml. As a result, a healthy full-term baby was born without congenital defects or developmental abnormalities.</p></abstract><trans-abstract xml:lang="ru"><p>Несмотря на предупреждения о необходимости соблюдения эффективных мер контрацепции при терапии терифлуномидом, ряд пациенток все же планируют беременность или сообщают врачу об уже состоявшейся беременности на фоне приема препарата. Согласно инструкции к препарату, в этих случаях следует немедленно прекратить терапию и провести процедуру ускоренного выведения терифлуномида до безопасной концентрации в плазме крови – не более 0,02 мкг/мл. Рекомендованный с этой целью препарат колестирамин в России не зарегистрирован. Предложенное альтернативное использование активированного угля по 50 г каждые 12 ч в течение 11 дней (400 таблеток в сутки) чревато нежелательными побочными эффектами в виде запоров, диареи, нарушения всасывания кальция, витаминов и других питательных веществ, что недопустимо для беременных женщин и может оказать негативное влияние на плод. Возникает вопрос: что делать в таких случаях? Нами продемонстрирован клинический случай ускоренной элиминации терифлуномида у беременной пациентки с помощью препарата Полисорб МП. Использование данной тактики позволило в течение 1 мес снизить концентрацию препарата в крови в 50 раз: с 1,39 до 0,028 мкг/мл. В результате родился здоровый доношенный ребенок без врожденных пороков и аномалий развития.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>рассеянный склероз</kwd><kwd>беременность</kwd><kwd>терифлуномид</kwd><kwd>процедура ускоренного выведения терифлуномида</kwd></kwd-group><kwd-group xml:lang="en"><kwd>multiple sclerosis</kwd><kwd>pregnancy</kwd><kwd>teriflunomide</kwd><kwd>accelerated teriflunomide elimination procedure</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Исследование не имело спонсорской поддержки</funding-statement><funding-statement xml:lang="en">The investigation has not been sponsored</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Гусев ЕИ, Бойко АН. Рассеянный склероз. Научно-практическое руководство в двух томах. Москва: РООИ «Здоровье человека»; 2020. Т. 2. 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