Clinical Outcome Measures Poster Presentation

P0141 - Real-world data on the use of Ocrelizumab, among MS patients: B-cell suppression and clinical outcomes. (ID 934)

Speakers
  • C. Neo
Authors
  • C. Neo
  • V. Singh-Curry
  • A. Nandoskar
  • O. Malik
  • R. Dorsey
  • P. Muraro
  • R. Nicholas
  • A. Scalfari
Presentation Number
P0141
Presentation Topic
Clinical Outcome Measures

Abstract

Background

Ocrelizumab (OCR) is an anti-CD20 B-cell-depleting agent, recently approved for treating relapsing-remitting (RR) MS.

Objectives

In a real-world population of RRMS patients, we described baseline characteristics and clinical outcomes in correlation with the level of OCR-induced B-cell suppression.

Methods

Data were retrospectively collected from 170 RRMS patients, who received 6-monthly 600mg OCR infusions at Imperial College Healthcare NHS Trust from August 2018 to March 2020. Disability progression was defined as ≥1.0 or ≥0.5 Expanded Disability Status Scale (EDSS) increase from baseline EDSS of ≤5.5 or ≥6 respectively. Patients were grouped by level of B-cell depletion after 6 months from the first OCR infusion relative to their baseline B-cell count, into categories of “depleted” (>90%) and “not depleted” (≤90%).

Results

The whole cohort (females 67%, males 33%) was followed up for 5.6 mean months (0-15 months) from OCR initiation. At baseline, the mean age was 45.5 years, the mean disease duration was 13.1 years and the mean EDSS was 4.3. While 15% of patients were treatment naïve, most patients (85%) were escalated to OCR from other disease-modifying therapies: Dimethyl Fumarate (30%), Fingolimod (16%), Alemtuzumab (15%) and Natalizumab (10%). Majority received at least 2 OCR infusions (36%, 51% and 13% with 1, 2 and 3 infusions respectively). The mean B-cell count at baseline was 272/mm3; after OCR initiation, 89% were “depleted” and 11% were “not depleted”. During the follow-up, 7% (n = 12) experienced a relapse and 20% (n = 27) showed disability progression at 4.8 and 6.5 mean months after OCR initiation, respectively. Those who relapsed had in larger proportion new MRI lesions 1 year before OCR initiation (58% vs 20%; p = 0.039) and those experiencing disability progression had longer disease duration (16.8 vs 12.1 mean years; p = 0.039). Although not statistically significant, compared to “depleted” patients, the group without adequate B-cell depletion had a worse clinical outcome, with a larger proportion experiencing a relapse (14% vs 7%; 4.5 vs 4.8 mean months to relapse; p = 0.297).

Conclusions

This study characterizes the use of OCR in a real-world population of RRMS patients. Data suggests that the level of B-cell suppression could be a potential marker of treatment response. This should be validated in further studies with longer follow-up.

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