Abstract Details

Title Trends and Predictors of Peripheral CD19+ B-cell Repopulation in Patients Treated with Ocrelizumab during COVID-19 Pandemic

Topic Multiple Sclerosis

Presentation(s) P7 - Poster Session 7 (8:00 AM-9:00 AM)

Poster/Presentation
Number 3-014

Objective

To assess the predictors of B-cell repopulation in patients treated with ocrelizumab during COVID-19 pandemic.

Background

Ocrelizumab (OCR) is used for multiple sclerosis (MS) administered every 6 months (SID). Peripheral CD19+ lymphocyte (CD19L) count is a surrogate marker of efficacy of OCR. B-cell repopulation (≥1% CD19L of total lymphocytes) is a potential biomarker to guide OCR extended interval dosing (EID) beyond 6 months. During COVID-19 pandemic, adjusted OCR treatment-cycle based on CD19L repopulation has been a strategy to minimize the risk of prolonged B-cell depletion associated higher potential complications of COVID. We studied the predictors of B-cell repopulation in patients treated with OCR.

Design/Methods Retrospective study of patients receiving OCR between 2020-2022 in whom CD19L counts were available <30 days prior to next infusion. Data collected included age, gender, race, body mass index (BMI), MS subtype, prior immunosuppressive therapy, time-to-repopulation. Multiple linear regression was used to look for predictors of B-cell repopulation.

Results Total 248 patients (mean age 48±12.8 years; 172 female, 76 male) studied. Forty-five percent (111 patients) had CD19L repopulation, fifty-five percent (137 patients) had persistently low (<1%) counts. Mean number of infusion cycles prior to CD19L repopulation was significantly longer in extended interval group (4.36±2.16 days vs. 2.33±2.04; p<0.05). BMI and inter-infusion interval were predictors of repopulation (p<0.001); age, race, gender, disease type, prior immunosuppressive therapy did not predict repopulation. All patients remained clinically stable.

Conclusions

In this observational study of MS patients treated with OCR with standard or extended interval dosing, BMI and inter-infusion dosing interval were the only predictors of B-cell repopulation. The number of infusions prior to repopulation was higher in the extended dosing group. In the future, these data can be used to provide guidance on extending OCR dosing interval.

Authors/Disclosures
Elizabeth Padron, MD PRESENTER	Dr. Padron has nothing to disclose.
Sopiko Jimsheleishvili, MD	Ms. Jimsheleishvili has nothing to disclose.
Leticia Tornes, MD, FAAN (University of Miami)	Dr. Tornes has nothing to disclose.
Sylvia R. Delgado, MD, FAAN (University of Miami School of Medicine)	The institution of Dr. Delgado has received research support from Novartis. The institution of Dr. Delgado has received research support from EMD Serono.
Neeta Garg, MD (Harbor UCLA Medical Center)	Dr. Garg has nothing to disclose.

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