Prediction of multiple sclerosis outcomes when switching to ocrelizumab.
(2022) Multiple Sclerosis Journal — Vol. 28, n° 6, p. 958-969 (2022)
Files
2022_Zhong_Mult_Scler_J_Ab.pdf
Abstract Scopus
Open Access - Adobe PDF
- 132.4 KB
2022_Zhong_Mult_Scler_J.pdf
Restricted Access - Adobe PDF
- 1.42 MB
Details
- Authors
van der Walt, Anneke 
Kalincik, Tomas Jokubaitis, Vilija G
- Abstract
- BACKGROUND: Increasingly, people with relapsing-remitting multiple sclerosis (RRMS) are switched to highly effective disease-modifying therapies (DMTs) such as ocrelizumab. OBJECTIVE: To determine predictors of relapse and disability progression when switching from another DMT to ocrelizumab. METHODS: Patients with RRMS who switched to ocrelizumab were identified from the MSBase Registry and grouped by prior disease-modifying therapy (pDMT; interferon-β/glatiramer acetate, dimethyl fumarate, teriflunomide, fingolimod or natalizumab) and washout duration (<1 month, 1-2 months or 2-6 months). Survival analyses including multivariable Cox proportional hazard regression models were used to identify predictors of on-ocrelizumab relapse within 1 year, and 6-month confirmed disability progression (CDP). RESULTS: After adjustment, relapse hazard when switching from fingolimod was greater than other pDMTs, but only in the first 3 months of ocrelizumab therapy (hazard ratio (HR) = 3.98, 95% confidence interval (CI) = 1.57-11.11, p = 0.004). The adjusted hazard for CDP was significantly higher with longer washout (2-6 m compared to <1 m: HR = 9.57, 95% CI = 1.92-47.64, p = 0.006). CONCLUSION: The risk of disability worsening during switch to ocrelizumab is reduced by short treatment gaps. Patients who cease fingolimod are at heightened relapse risk in the first 3 months on ocrelizumab. Prospective evaluation of strategies such as washout reduction may help optimise this switch.
- Affiliations
Citations
Zhong, M., van der Walt, A., Stankovich, J., Kalincik, T., Buzzard, K., Skibina, O., Boz, C., Hodgkinson, S., Slee, M., Lechner-Scott, J., Macdonell, R., Prevost, J., Kuhle, J., Laureys, G., Van Hijfte, L., Alroughani, R., Kermode, A. G., Butler, E., Barnett, M., et al. (2022). Prediction of multiple sclerosis outcomes when switching to ocrelizumab. Multiple Sclerosis Journal, 28(6), 958-969. https://doi.org/10.1177/13524585211049986 (Original work published 2022)