Abstract Details

Title Recurrent MRI Activity After Treatment with Ocrelizumab for Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) MS and CNS Inflammatory Disease Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 245

Objective Treatment with ocrelizumab (OCR) for multiple sclerosis (MS) is associated with 5% or fewer rate of new gadolinium (Gd)-enhancing lesions on MRI.

Background To characterize MRI activity during treatment with OCR in a clinical cohort.

Design/Methods Retrospective review of MRI in patients with MS treated with OCR in the CLIMB cohort at Brigham and Women’s Hospital. Brain or spinal cord MRI was “active” with any of the following: (1) Gd enhancement (2) new restricted diffusivity of a lesion, or (3) new or enlarging T2 lesion compared to a baseline MRI acquired at or after start of OCR.

Results There were 383 patients treated with OCR [68% female, mean age 48.4 (SD 12.3) years, median EDSS 2.5 (range 0-8) of whom 68% had relapsing-remitting, 21% secondary progressive, and 11% primary progressive multiple sclerosis. Final MRI was obtained average of 14.2 (SD 7.3) months after starting OCR. In total, there were 25 MRI relapses identified in 24 (6.2%) patients [23 new Gd enhancing, 1 new restricted diffusion, 1 new T2 lesion]. Patients with MRI activity were 63% female with mean age of 41.4 (SD 11.3) years, median EDSS of 3 of whom 79% had relapsing-remitting and 21% with secondary progressive MS. There were two distinct patterns of relapse. The predominant pattern was gadolinium enhancement or restricted diffusion of an old T2 lesion present prior to start of OCR. This pattern occurred in 14 MRI scans (6 brain, 8 spinal cord) acquired median 9 months after OCR start. The second pattern was new lesion formation, present in 11 MRI scans (8 brain, 3 spinal cord) obtained median of 5 months after OCR start.

Conclusions The more common pattern of radiological relapse on OCR surprisingly was recurrent MRI activity at an old lesion site with predominance in the spinal cord.

Authors/Disclosures
Shamik Bhattacharyya, MD, FAAN (Brigham and Women's Hospital) PRESENTER	Dr. Bhattacharyya has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NeuroLambda. Dr. Bhattacharyya has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion Pharmaceuticals. Dr. Bhattacharyya has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Bhattacharyya has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Bhattacharyya has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Continuum. Dr. Bhattacharyya has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley. Dr. Bhattacharyya has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Merck. The institution of Dr. Bhattacharyya has received research support from Alexion Pharmaceuticals. The institution of Dr. Bhattacharyya has received research support from National Institute of Health. The institution of Dr. Bhattacharyya has received research support from UCB. The institution of Dr. Bhattacharyya has received research support from Genentech. Dr. Bhattacharyya has received publishing royalties from a publication relating to health care. Dr. Bhattacharyya has received publishing royalties from a publication relating to health care.
Ahya S. Ali, MD (Westchester Medical Center)	Dr. Ali has nothing to disclose.
Rohit Bakshi, MD, FAAN	Dr. Bakshi has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Bakshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. The institution of Dr. Bakshi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Neuroimaging. The institution of Dr. Bakshi has received research support from Bristol Myers Squibb. The institution of Dr. Bakshi has received research support from EMD Serono. The institution of Dr. Bakshi has received research support from Novartis.

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