Interleukin-6 Receptor Blockade in Treatment-Refractory MOG-IgG-Associated Disease and Neuromyelitis Optica Spectrum Disorders.
Adult
Antibodies, Monoclonal, Humanized
/ administration & dosage
Aquaporin 4
/ immunology
Demyelinating Autoimmune Diseases, CNS
/ drug therapy
Female
Humans
Male
Middle Aged
Myelin-Oligodendrocyte Glycoprotein
/ immunology
Neuromyelitis Optica
/ drug therapy
Outcome Assessment, Health Care
Receptors, Interleukin-6
/ antagonists & inhibitors
Secondary Prevention
Young Adult
Journal
Neurology(R) neuroimmunology & neuroinflammation
ISSN: 2332-7812
Titre abrégé: Neurol Neuroimmunol Neuroinflamm
Pays: United States
ID NLM: 101636388
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
received:
08
02
2021
accepted:
25
08
2021
entrez:
17
11
2021
pubmed:
18
11
2021
medline:
12
3
2022
Statut:
epublish
Résumé
To evaluate the long-term safety and efficacy of tocilizumab (TCZ), a humanized anti-interleukin-6 receptor antibody in myelin oligodendrocyte glycoprotein-IgG-associated disease (MOGAD) and neuromyelitis optica spectrum disorders (NMOSD). Annualized relapse rate (ARR), Expanded Disability Status Scale score, MRI, autoantibody titers, pain, and adverse events were retrospectively evaluated in 57 patients with MOGAD (n = 14), aquaporin-4 (AQP4)-IgG seropositive (n = 36), and seronegative NMOSD (n = 7; 12%), switched to TCZ from previous immunotherapies, particularly rituximab. Patients received TCZ for 23.8 months (median; interquartile range 13.0-51.1 months), with an IV dose of 8.0 mg/kg (median; range 6-12 mg/kg) every 31.6 days (mean; range 26-44 days). For MOGAD, the median ARR decreased from 1.75 (range 0.5-5) to 0 (range 0-0.9; This study provides Class III evidence that long-term TCZ therapy is safe and reduces relapse probability in MOGAD and AQP4-IgG+ NMOSD.
Sections du résumé
BACKGROUND AND OBJECTIVES
To evaluate the long-term safety and efficacy of tocilizumab (TCZ), a humanized anti-interleukin-6 receptor antibody in myelin oligodendrocyte glycoprotein-IgG-associated disease (MOGAD) and neuromyelitis optica spectrum disorders (NMOSD).
METHODS
Annualized relapse rate (ARR), Expanded Disability Status Scale score, MRI, autoantibody titers, pain, and adverse events were retrospectively evaluated in 57 patients with MOGAD (n = 14), aquaporin-4 (AQP4)-IgG seropositive (n = 36), and seronegative NMOSD (n = 7; 12%), switched to TCZ from previous immunotherapies, particularly rituximab.
RESULTS
Patients received TCZ for 23.8 months (median; interquartile range 13.0-51.1 months), with an IV dose of 8.0 mg/kg (median; range 6-12 mg/kg) every 31.6 days (mean; range 26-44 days). For MOGAD, the median ARR decreased from 1.75 (range 0.5-5) to 0 (range 0-0.9;
DISCUSSION
This study provides Class III evidence that long-term TCZ therapy is safe and reduces relapse probability in MOGAD and AQP4-IgG+ NMOSD.
Identifiants
pubmed: 34785575
pii: 9/1/e1100
doi: 10.1212/NXI.0000000000001100
pmc: PMC8596357
pii:
doi:
Substances chimiques
AQP4 protein, human
0
Antibodies, Monoclonal, Humanized
0
Aquaporin 4
0
IL6R protein, human
0
MOG protein, human
0
Myelin-Oligodendrocyte Glycoprotein
0
Receptors, Interleukin-6
0
tocilizumab
I031V2H011
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.
Références
Neurology. 2014 Apr 15;82(15):1302-6
pubmed: 24634453
N Engl J Med. 2019 Aug 15;381(7):614-625
pubmed: 31050279
Brain. 2017 Dec 1;140(12):3128-3138
pubmed: 29136091
Neurol Neuroimmunol Neuroinflamm. 2020 Aug 20;7(5):
pubmed: 32820020
Neurology. 2015 Jul 14;85(2):177-89
pubmed: 26092914
Mult Scler. 2020 Dec;26(14):1854-1865
pubmed: 31937191
Neuropediatrics. 2019 Jun;50(3):193-196
pubmed: 30913570
J Neuroinflammation. 2012 Jan 19;9:14
pubmed: 22260418
J Neuroinflammation. 2019 Jul 2;16(1):134
pubmed: 31266527
Neurology. 2020 Jul 14;95(2):e111-e120
pubmed: 32554760
Mult Scler Relat Disord. 2020 Nov;46:102592
pubmed: 33296987
Mult Scler Relat Disord. 2019 Jan;27:312-314
pubmed: 30469022
JAMA Neurol. 2015 Jul;72(7):756-63
pubmed: 25985228
Neurol Neuroimmunol Neuroinflamm. 2016 Dec 19;4(1):e311
pubmed: 28018943
Neurochem Int. 2019 Nov;130:104315
pubmed: 30342072
Mult Scler Relat Disord. 2021 Feb;48:102696
pubmed: 33360264
Neurology. 2019 Apr 16;92(16):765-767
pubmed: 30894449
Neurology. 2007 Feb 20;68(8):603-5
pubmed: 17310032
Eur J Neurol. 2021 May;28(5):1645-1658
pubmed: 33423336
PLoS One. 2016 Feb 26;11(2):e0149411
pubmed: 26919719
Handb Clin Neurol. 2014;122:581-99
pubmed: 24507536
Ann Neurol. 2020 Aug;88(2):430
pubmed: 32495967
Mult Scler Relat Disord. 2019 Dec 30;39:101920
pubmed: 31918241
Neurol Neuroimmunol Neuroinflamm. 2020 Mar 13;7(3):
pubmed: 32170045
J Neuroinflammation. 2016 Nov 1;13(1):282
pubmed: 27802824
Ann Neurol. 2020 Feb;87(2):256-266
pubmed: 31725931
Neurology. 2018 May 22;90(21):e1858-e1869
pubmed: 29695592
J Neurol Neurosurg Psychiatry. 2018 Sep;89(9):927-936
pubmed: 29875186
J Neuroinflammation. 2016 Sep 26;13(1):279
pubmed: 27788675
N Engl J Med. 2019 Nov 28;381(22):2114-2124
pubmed: 31774956
Lancet. 2019 Oct 12;394(10206):1352-1363
pubmed: 31495497
JAMA Neurol. 2013 Mar 1;70(3):394-7
pubmed: 23358868
Mult Scler. 2010 Dec;16(12):1443-52
pubmed: 20739337
Neurology. 2006 May 23;66(10):1485-9
pubmed: 16717206
Mult Scler Relat Disord. 2020 Sep;44:102251
pubmed: 32629363
JAMA Neurol. 2020 Dec 1;77(12):1575-1577
pubmed: 32865549
Neurology. 2018 May 22;90(21):947-948
pubmed: 29695599
Curr Neuropharmacol. 2021;19(2):220-232
pubmed: 32348222
Lancet Neurol. 2020 May;19(5):402-412
pubmed: 32333898
Nat Commun. 2020 Jun 5;11(1):2856
pubmed: 32503977
Acta Neuropathol. 2020 May;139(5):875-892
pubmed: 32048003
J Neuroinflammation. 2018 May 3;15(1):134
pubmed: 29724224
Proc Natl Acad Sci U S A. 2011 Mar 1;108(9):3701-6
pubmed: 21321193
Mult Scler Relat Disord. 2020 Nov;46:102483
pubmed: 32942119
Curr Opin Neurol. 2020 Jun;33(3):362-371
pubmed: 32304439
J Neuroinflammation. 2016 Sep 27;13(1):280
pubmed: 27793206
J Neurol Neurosurg Psychiatry. 2018 Feb;89(2):127-137
pubmed: 29142145
Lancet Neurol. 2020 May;19(5):391-401
pubmed: 32333897
Lancet Neurol. 2020 Apr;19(4):298-306
pubmed: 32199095