PT  - JOURNAL ARTICLE
AU  - Leoni Rolfes
AU  - Marc Pawlitzki
AU  - Steffen Pfeuffer
AU  - Christopher Nelke
AU  - Anke Lux
AU  - Refik Pul
AU  - Christoph Kleinschnitz
AU  - Konstanze Kleinschnitz
AU  - Rebeca Rogall
AU  - Katrin Pape
AU  - Stefan Bittner
AU  - Frauke Zipp
AU  - Clemens Warnke
AU  - Yasemin Goereci
AU  - Michael Schroeter
AU  - Jens Ingwersen
AU  - Orhan Aktas
AU  - Luisa Klotz
AU  - Tobias Ruck
AU  - Heinz Wiendl
AU  - Sven G. Meuth
TI  - Ocrelizumab Extended Interval Dosing in Multiple Sclerosis in Times of COVID-19
AID  - 10.1212/NXI.0000000000001035
DP  - 2021 Sep 01
TA  - Neurology - Neuroimmunology Neuroinflammation
PG  - e1035
VI  - 8
IP  - 5
4099  - http://nn.neurology.org/content/8/5/e1035.short
4100  - http://nn.neurology.org/content/8/5/e1035.full
SO  - Neurol Neuroimmunol Neuroinflamm2021 Sep 01; 8
AB  - Objective To evaluate the clinical consequences of extended interval dosing (EID) of ocrelizumab in relapsing-remitting multiple sclerosis (RRMS) during the coronavirus disease 2019 (COVID-19) pandemic.Methods In our retrospective, multicenter cohort study, we compared patients with RRMS on EID (defined as ≥4-week delay of dose interval) with a control group on standard interval dosing (SID) at the same period (January to December 2020).Results Three hundred eighteen patients with RRMS were longitudinally evaluated in 5 German centers. One hundred sixteen patients received ocrelizumab on EID (median delay [interquartile range 8.68 [5.09–13.07] weeks). Three months after the last ocrelizumab infusion, 182 (90.1%) patients following SID and 105 (90.5%) EID patients remained relapse free (p = 0.903). Three-month confirmed progression of disability was observed in 18 SID patients (8.9%) and 11 EID patients (9.5%, p = 0.433). MRI progression was documented in 9 SID patients (4.5%) and 8 EID patients (6.9%) at 3-month follow-up (p = 0.232). Multivariate logistic regression showed no association between treatment regimen and no evidence of disease activity status at follow-up (OR: 1.266 [95% CI: 0.695–2.305]; p = 0.441). Clinical stability was accompanied by persistent peripheral CD19+ B-cell depletion in both groups (SID vs EID: 82.6% vs 83.3%, p = 0.463). Disease activity in our cohort was not associated with CD19+ B-cell repopulation.Conclusion Our data support EID of ocrelizumab as potential risk mitigation strategy in times of the COVID-19 pandemic.Classification of Evidence This study provides Class IV evidence that for patients with RRMS, an EID of at least 4 weeks does not diminish effectiveness of ocrelizumab.COVID-19=coronavirus disease 2019; CPD=confirmed progression of disability; EDSS=Expanded Disability Status Scale; EID=extended interval dosing; IQR=interquartile range; NEDA-3=no evidence of disease activity; RRMS=relapsing-remitting multiple sclerosis; SID=standard interval dosing