Abstract Details

Title African-American MS Patients with and Without Early B-cell Repletion After Anti-CD20 Monoclonal Infusion Therapy Have Similarly Low Levels of Disease Activity

Topic Multiple Sclerosis

Presentation(s) P10 - Poster Session 10 (5:00 PM-6:00 PM)

Poster/Presentation
Number 1-009

Objective To compare disease activity in MS patients of African descent on anti-CD20 therapy with early B-cell repletion (‘early repletion’, ER) to patients without early B-cell repletion (‘normal repletion’, NR).

Background Infusable anti-CD20 therapies cause complete peripheral B-cell depletion for 6 months following treatment in >95% of patients in clinical trials, though African ancestry is associated with earlier B-cell repletion. It is not known whether relapses and/or new MRI lesions are more common in patients with early B-cell repletion.

Design/Methods We retrospectively reviewed charts of African-American patients with MS attending the NYU Multiple Sclerosis Care Center on anti-CD20 therapy. We identified ER and NR patients with similar demographic characteristics and extracted data on neurologist-confirmed relapses and MRI activity for the duration of anti-CD20 therapy. Exclusion criteria were BMI>40 and >12 month breaks in therapy. Annual relapse rates and new MRI lesion formation were compared between the groups using a z-test for proportions.

Results We identified 18 patients with ER (female=14, age: mean=37.9 years [SD=12.9], mean duration on anti-CD20 therapy=5 years) and 23 patients with NR (female=20, age: mean=42.3 years [SD=9.9], mean duration on anti-CD20 therapy=4.9 years). Relapses were recorded in 4 ER patients (22%; mean annual relapse rate of 4%) and 5 NR patients (22%; mean annual relapse rate of 4%) (p=0.998). 88 MRI were reviewed in ER group and 91 MRI in NR group. New MRI lesions were observed in 4 ER patients (22%; mean annual lesion formation rate of 4%) and in 3 NR patients (13%; mean annual lesion formation rate of 2.7%) (p=0.816).

Conclusions

In anti-CD20 treated African-American patients with MS, disease activity was similarly low with or without early B-cell repletion. Our findings are consistent with the growing evidence that re-emergence of B-cells with an extended anti-CD20 dosing period is not associated with disease recurrence.

Authors/Disclosures
Hannah Kopinsky, MD PRESENTER	Dr. Kopinsky has nothing to disclose.
Angie H. Kim	Ms. Kim has nothing to disclose.
Abhimanyu Amarnani, MD, PhD	Dr. Amarnani has nothing to disclose.
Arnaldo A. Arbini, MD	Dr. Arbini has nothing to disclose.
David Fenyo, PhD	Dr. Fenyo has nothing to disclose.
Gregg J. Silverman (NYU Grossman School of Medicine)	No disclosure on file
Ilya Kister, MD, FAAN (NYU School of Medicine)	Dr. Kister has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech-Roche. Dr. Kister has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. The institution of Dr. Kister has received research support from Genentech. The institution of Dr. Kister has received research support from Novartis. Dr. Kister has received publishing royalties from a publication relating to health care.

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