Prediction of multiple sclerosis outcomes when switching to ocrelizumab.

Humans Antibodies, Monoclonal, Humanized Fingolimod Hydrochloride / therapeutic use Immunosuppressive Agents / therapeutic use Multiple Sclerosis / chemically induced Multiple Sclerosis, Relapsing-Remitting / drug therapy Recurrence
Ocrelizumab fingolimod switch washout

Journal

Multiple sclerosis (Houndmills, Basingstoke, England)
ISSN: 1477-0970
Titre abrégé: Mult Scler
Pays: England
ID NLM: 9509185

Informations de publication

Date de publication:
05 2022
Historique:
pubmed: 9 10 2021
medline: 22 4 2022
entrez: 8 10 2021
Statut: ppublish

Résumé

Increasingly, people with relapsing-remitting multiple sclerosis (RRMS) are switched to highly effective disease-modifying therapies (DMTs) such as ocrelizumab. To determine predictors of relapse and disability progression when switching from another DMT to ocrelizumab. 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). 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, 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.

Sections du résumé

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,
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.

Identifiants

DOI: 10.1177/13524585211049986 PMID: 34623947
pubmed: 34623947
doi: 10.1177/13524585211049986
doi:

Substances chimiques

Antibodies, Monoclonal, Humanized 0
Fingolimod Hydrochloride G926EC510T
Immunosuppressive Agents 0
ocrelizumab A10SJL62JY

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

958-969

Auteurs

Michael Zhong (M)

Central Clinical School, Monash University, Melbourne, VIC, Australia/Department of Neurology, The Alfred Hospital, Melbourne, VIC, Australia.

Anneke van der Walt (A)

Central Clinical School, Monash University, Melbourne, VIC, Australia/Department of Neurology, The Alfred Hospital, Melbourne, VIC, Australia.
ORCID: 0000-0002-4278-7003

Jim Stankovich (J)

Central Clinical School, Monash University, Melbourne, VIC, Australia.

Tomas Kalincik (T)

CORe, Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia/MS Centre, Department of Neurology, The Royal Melbourne Hospital, Melbourne, VIC, Australia.
ORCID: 0000-0003-3778-1376

Katherine Buzzard (K)

MS Centre, Department of Neurology, The Royal Melbourne Hospital, Melbourne, VIC, Australia/Department of Neurology, Box Hill Hospital, Melbourne, VIC, Australia/Monash University, Melbourne, VIC, Australia.

Olga Skibina (O)

Department of Neurology, The Alfred Hospital, Melbourne, VIC, Australia/Department of Neurology, Box Hill Hospital, Melbourne, VIC, Australia/Monash University, Melbourne, VIC, Australia.

Cavit Boz (C)

KTU Medical Faculty, Farabi Hospital, Trabzon, Turkey.

Suzanne Hodgkinson (S)

Liverpool Hospital, Sydney, NSW, Australia.

Mark Slee (M)

Flinders University, Adelaide, SA, Australia.

Jeannette Lechner-Scott (J)

School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia/Department of Neurology, John Hunter Hospital, Hunter New England Health, Newcastle, NSW, Australia.
ORCID: 0000-0002-3850-447X

Richard Macdonell (R)

Department of Neurology, Austin Health, Melbourne, VIC, Australia.

Julie Prevost (J)

CSSS Saint-Jérôme, Saint-Jérôme, QC, Canada.

Jens Kuhle (J)

Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.

Guy Laureys (G)

Department of Neurology, University Hospital Ghent, Ghent, Belgium.

Liesbeth Van Hijfte (L)

Department of Neurology, University Hospital Ghent, Ghent, Belgium.

Raed Alroughani (R)

Division of Neurology, Department of Medicine, Amiri Hospital, Sharq, Kuwait.
ORCID: 0000-0001-5436-5804

Allan G Kermode (AG)

Perron Institute, The University of Western Australia, Perth, WA, Australia/Institute of Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia.
ORCID: 0000-0002-4476-4016

Ernest Butler (E)

Monash Medical Centre, Melbourne, VIC, Australia.

Michael Barnett (M)

Brain and Mind Centre, Sydney, NSW, Australia.
ORCID: 0000-0002-2156-8864

Sara Eichau (S)

Hospital Universitario Virgen Macarena, Sevilla, Spain.
ORCID: 0000-0001-9159-3128

Vincent van Pesch (V)

Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium.

Pierre Grammond (P)

CISSS Chaudière-Appalache, Levis, QC, Canada.

Pamela McCombe (P)

Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.

Rana Karabudak (R)

Department of Neurology, Hacettepe University, Ankara, Turkey.

Pierre Duquette (P)

CHUM and Universite de Montreal, Montreal, QC, Canada.

Marc Girard (M)

CHUM and Universite de Montreal, Montreal, QC, Canada.

Bruce Taylor (B)

Royal Hobart Hospital, Hobart, TAS, Australia.

Wei Yeh (W)

Central Clinical School, Monash University, Melbourne, VIC, Australia/Department of Neurology, The Alfred Hospital, Melbourne, VIC, Australia.

Mastura Monif (M)

Central Clinical School, Monash University, Melbourne, VIC, Australia/Department of Neurology, The Alfred Hospital, Melbourne, VIC, Australia/MS Centre, Department of Neurology, The Royal Melbourne Hospital, Melbourne, VIC, Australia.
ORCID: 0000-0001-6404-9768

Melissa Gresle (M)

Central Clinical School, Monash University, Melbourne, VIC, Australia.

Helmut Butzkueven (H)

Central Clinical School, Monash University, Melbourne, VIC, Australia/Department of Neurology, The Alfred Hospital, Melbourne, VIC, Australia.

Vilija G Jokubaitis (VG)

Central Clinical School, Monash University, Melbourne, VIC, Australia/Department of Neurology, The Alfred Hospital, Melbourne, VIC, Australia.
ORCID: 0000-0002-3942-4340

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Prediction of multiple sclerosis outcomes when...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Globulines › Sérum-globulines › Immunoglobulines › Anticorps › Anticorps monoclonaux › Anticorps monoclonaux humanisés › Prediction of multiple sclerosis outcomes when...
questionsmedicales.fr › Composés chimiques organiques › Amines › Aminoalcools › Sphingosine › Chlorhydrate de fingolimod › Prediction of multiple sclerosis outcomes when...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Effets physiologiques des médicaments › Facteurs immunologiques › Immunosuppresseurs › Prediction of multiple sclerosis outcomes when...
questionsmedicales.fr › Maladies du système immunitaire › Maladies auto-immunes › Maladies auto-immunes du système nerveux › Maladies démyélinisantes auto-immunes du SNC › Sclérose en plaques › Prediction of multiple sclerosis outcomes when...
questionsmedicales.fr › Maladies du système immunitaire › Maladies auto-immunes › Maladies auto-immunes du système nerveux › Maladies démyélinisantes auto-immunes du SNC › Sclérose en plaques › Sclérose en plaques récurrente-rémittente › Prediction of multiple sclerosis outcomes when...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Récidive › Prediction of multiple sclerosis outcomes when...