The recurrence of disease activity after ocrelizumab discontinuation in multiple sclerosis

Coerver, E., Schoof, L., Hogenboom, L., Wessels, M., van Ruyven, P., van Samkar, A., Mostert, J., van Kempen, Z., van Oosten, B.W., Wokke, B.H., Tallantyre, E. ORCID: https://orcid.org/0000-0002-3760-6634, Myhr, KM., Torkildsen, O., Killestein, J., Smets, I. and Strijbis, E. 2024. The recurrence of disease activity after ocrelizumab discontinuation in multiple sclerosis. Multiple Sclerosis and Related Disorders 91 , 105900. 10.1016/j.msard.2024.105900

PDF - Published Version Available under License Creative Commons Attribution. Download (1MB)

Abstract

Introduction Ocrelizumab (OCR) is a highly effective treatment of multiple sclerosis (MS), and B cell repopulation profiles suggest that it might be used as an immune reconstitution therapy. However, data on disease recurrence after stopping treatment with OCR are scarce. Our objective was to evaluate the recurrence of disease activity after OCR discontinuation. Methods In this multicenter retrospective cohort study, we included MS patients who discontinued OCR, without switching to another treatment, for twelve months or more, after having received at least one full dosage of 600 mg. We defined focal inflammation as the occurrence of a clinical relapse or significant MRI activity (≥3 new T2 lesions or ≥2 contrast-enhancing lesions). Results We included 53 MS patients; 41 relapsing remitting (RRMS), 5 secondary progressive (SPMS) and 7 primary progressive (PPMS) patients. Median follow-up period after OCR discontinuation was 16 months. We only observed focal inflammation after discontinuation in RRMS patients; 2.4 % (1/41) patients presented with significant MRI activity and matching clinical symptoms, and 7.3 % (3/41) patients presented with a suspected clinical relapse without radiological activity: a total of 9.8 % (4/41) at a median time of 17 months after the last infusion. Discussion We found focal inflammation after discontinuation of OCR in 4 (9.8 %) of the RRMS patients, of which 1 was radiologically confirmed. Our observations highlight that recurrence of focal inflammation seems low but discontinuation may not be appropriate for everyone. Further larger studies are important to determine the immune reconstitution therapy potential of OCR.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Elsevier
ISSN:	2211-0348
Date of First Compliant Deposit:	9 October 2024
Date of Acceptance:	18 September 2024
Last Modified:	15 Oct 2024 12:30
URI:	https://orca.cardiff.ac.uk/id/eprint/172751

Actions (repository staff only)

Edit Item