Author Of 1 Presentation
P0906 - Real-world Experience of Ocrelizumab initiation in a Diverse MS population (ID 1692)
Ocrelizumab is a humanized monoclonal antibody against CD20 positive B-lymphocytes, which has been approved for relapsing-remitting and primary progressive forms of multiple sclerosis (MS) since March 2017.
To provide real-world experience on patients with MS treated with ocrelizumab in our center along with safety and efficacy across different ethnic groups not studied in clinical trials.
This is a retrospective observational analysis of MS patients treated with Ocrelizumab from March 31st, 2017 to April 30th, 2020. We collected data from patients who had received at least one infusion of ocrelizumab at our MS center. Patient characteristics, including demographics, clinical disease course, documented side effects, were collected and analyzed.
A total of 82 patients were eligible for this study, of which 72% were relapsing-remitting MS, mean disease duration was 7.6 years, 14% had primary progressive MS, duration of 3.5 years, and 11% active/relapsing secondary progressive MS patients with a duration of 17.8 years. 22% of our patients were from African American descent, 61% Caucasian, and 17% from Hispanic descent, which is different from the clinical trial population. Mean age at starting ocrelizumab was 41 + 11. 47% were treatment naïve when they were started on ocrelizumab, 24% treated with 1 DMT, 14% treated with 2 DMTs, 15% treated with >2 DMTs before ocrelizumab. 50% of patients had at least one adverse event on ocrelizumab, 4.8% had adverse events leading to discontinuation of ocrelizumab, 36% had infusion-related reactions, 7.3% had viral infections, we report one case of babesiosis, re-activation of lichen planus, agranulocytosis, severe lymphopenia, ectopic pregnancy. There was no malignancy, progressive multifocal leukoencephalopathy (PML) or death in our patient population. The mean duration on ocrelizumab was 17.3 months in the RRMS group, 28.2 months in SPMS, 22.2 months in the PPMS group. Annualized relapse rate reduced from 1.33 to 0.015 in the RRMS group while on ocrelizumab, median extended disability status scale (EDSS) scores remained stable across MS phenotypes and ethnicity groups
In a diverse patient population ocrelizumab was well tolerated without significant adverse events. There were index cases of babesiosis, re-activation of lichen planus, lymphopenia, agranulocytosis, and ectopic pregnancy. It is vital to consider geographic risk factors that may expose patients to babesia microti while in Ocrevus, since there are three additional cases reported to the FDA database and multiple cases with other anti-CD20 medications. No malignancy, PML or death was seen in our patient population. Ocrelizumab was effective with decreased relapse rate and stable EDSS scores across MS phenotypes as well as different ethnic groups. Our study extends the generalizability of the effectiveness of ocrelizumab from clinical trials to a real-world setting in a diverse population