Ocrelizumab (OCR) was approved for relapsing and primary progressive forms of multiple sclerosis (MS) in 2017. Patient-reported outcome data among patients initiating OCR in clinical practice is limited.
To evaluate the characteristics, experience and outcomes of participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) registry who initiated OCR.
NARCOMS is a voluntary registry enrolling persons with MS who update their information using semi-annual surveys. This analysis included participants initiating OCR between April 2017 and April 2019, including a subset of participants who completed 1-year follow-ups. Outcomes included Patient Determined Disease Steps (PDDS), relapses, health care utilization and employment (i.e. employed/unemployed status, absenteeism). Changes from baseline for the subgroup who completed 1-year surveys were evaluated using the nonparametric Wilcoxon-Signed Rank or McNemar’s tests.
During the study period 829 participants initiated OCR. They had a mean [SD] age of 56.6 [10.6] years and time since diagnosis of 18.7 [9.9] years. Most participants were female (75.3%). The most common clinical course was relapsing-remitting (45.4%) followed by secondary progressive (32.1%) and primary progressive (22.6%). The median (interquartile range [IQR]) PDDS was 5.0 [3.0–6.0]. Similar baseline characteristics were observed in the subgroup of 435 participants who had ≥1 year of follow-up (median [IQR] follow-up, 1.5 [1.0–2.0] years). In this subgroup, participants were less likely to report a steroid-treated relapse at 1 year (7.7%) compared with baseline (1-year lookback, 4.7%; p=0.04), although no differences were observed with respect to emergency room or hospital admissions. More than half of participants reported either improvement (40.7%) or no change (15.3%) on the PDDS; 44% reported worsening. Among employed participants at baseline (n=139), 8% reported leaving the workforce during follow-up; among those who remained employed, fewer reported missing work in the follow-up year (33.9%) compared with baseline (1-year lookback; 46.5%; p=0.003).
Participants initiating ocrelizumab in the NARCOMS registry are representative of a prevalent MS population, consistent with the full registry population. Patients with longitudinal follow-up on ocrelizumab reported fewer relapses and lower work absenteeism, with no differences in health resource utilization compared to baseline.