Abstract Details

Title Extended Interval Dosing of Ocrelizumab in Patients with Multiple Sclerosis Is Not Associated with Meaningful Differences in Disease Activity

Topic Multiple Sclerosis

Presentation(s) P14 - Poster Session 14 (11:45 AM-12:45 PM)

Poster/Presentation
Number 3-010

Objective To determine if extended interval dosing (EID) of ocrelizumab is associated with changes in disease activity in patients with multiple sclerosis (MS).

Background

During the COVID-19 pandemic, EID of ocrelizumab (standard interval dosing (SID)= every 6 months) was employed variably by neurologists at our center due to concerns about COVID-19 risk or reduced COVID-19 vaccine efficacy. This time period provides the opportunity to evaluate whether EID is associated with greater risk of breakthrough MS activity.

Design/Methods

Medical records of patients at our institution who were on ocrelizumab treatment as of March 2020 were reviewed. Demographic, clinical, and imaging data and infusion dates were collected. EID was defined as ≥ 8 months in the primary analysis and ≥ 12 months in secondary analyses.

Results Overall, 364 patients, 275 (75.5%) with relapsing-remitting MS (RRMS) and 89 (24.5%) with progressive MS (PMS), were included (mean age 42.4±10.9 years; 72% females). They received ocrelizumab for an average of 38.2±14.9 months; and infusion intervals ranged from 4 to 32 months. 190 patients (52.4% of RRMS and 51.6% of PMS) had at least one EID ≥ 8 months, while 89 patients (21% of RRMS and 18% of PMS) had at least one EID ≥ 12 months. There was no difference in sex, age, or MS type between EID and SID groups. Reasons for EID (≥ 8 months) included COVID concerns (58%), infections (8%), pregnancy (8%), or other (26%). Only 1 EID and 1 SID patient had a clinical relapse. Among 258 RRMS patients who had re-baseline MRI after starting ocrelizumab, 3 (2.2%) EID patients (≥ 8 months) had new lesions on imaging vs none in those with SID. No participant with PMS had breakthrough MRI activity.

Conclusions

Results suggest no marked risk of inflammatory MS activity associated with EID for ocrelizumab when compared to SID.

Authors/Disclosures
Nicole Bou Rjeily, MD (Johns Hopkins University School of Medicine) PRESENTER	Dr. Bou Rjeily has nothing to disclose.
Kathryn Fitzgerald, PhD (Johns Hopkins University)	Dr. Fitzgerald has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Setpoint Medical. The institution of Dr. Fitzgerald has received research support from NIH. The institution of Dr. Fitzgerald has received research support from National MS Society.
Ellen M. Mowry, MD, FAAN (Johns Hopkins University)	Dr. Mowry has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Octave. Dr. Mowry has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for SetPoint. The institution of Dr. Mowry has received research support from Genentech/Roche. The institution of Dr. Mowry has received research support from Biogen. Dr. Mowry has received publishing royalties from a publication relating to health care.

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