RT Journal Article
SR Electronic
T1 Ocrelizumab Extended Interval Dosing in Multiple Sclerosis in Times of COVID-19
JF Neurology - Neuroimmunology Neuroinflammation
JO Neurol Neuroimmunol Neuroinflamm
FD Lippincott Williams & Wilkins
SP e1035
DO 10.1212/NXI.0000000000001035
VO 8
IS 5
A1 Leoni Rolfes
A1 Marc Pawlitzki
A1 Steffen Pfeuffer
A1 Christopher Nelke
A1 Anke Lux
A1 Refik Pul
A1 Christoph Kleinschnitz
A1 Konstanze Kleinschnitz
A1 Rebeca Rogall
A1 Katrin Pape
A1 Stefan Bittner
A1 Frauke Zipp
A1 Clemens Warnke
A1 Yasemin Goereci
A1 Michael Schroeter
A1 Jens Ingwersen
A1 Orhan Aktas
A1 Luisa Klotz
A1 Tobias Ruck
A1 Heinz Wiendl
A1 Sven G. Meuth
YR 2021
UL http://nn.neurology.org/content/8/5/e1035.abstract
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