How do you optimize a beta thalassemia patient on luspatercept who is interested in becoming pregnant?

Unfortunately, luspatercept is not approved to be used during pregnancy - there is no data available on the safety of the drug during pregnancy. So would say that if the patient is planning a pregnancy, would stop luspatercept at least 3 months prior.

It is strongly recommended to optimize iron balance prior to pregnancy and get the liver iron down as low as possible in the 2-5 mg/g range. This way, the increase in iron levels through the pregnancy will not raise the iron too much and also optimize cardiac iron management.

If on chelation, would suggest stopping it as soon as the patient learns she is pregnant. Would not recommend stopping it in the planning stages. Chelation is usually held through the entire pregnancy, unless the patient ...