Ocrelizumab in MS patients with persistence of disease activity after alemtuzumab: A multi-center Italian study-Reference-Cited by-同舟云学术

Ocrelizumab in MS patients with persistence of disease activity after alemtuzumab: A multi-center Italian study

Published:2024-08 Issue:9 Volume:30 Page:1151-1162
ISSN:1352-4585
Container-title:Multiple Sclerosis Journal
language:en
Short-container-title:Mult Scler

Author:

Lapucci Caterina¹,Frau Jessica²,Cocco Eleonora²³^ORCID,Coghe Giancarlo²,Petracca Maria⁴^ORCID,Lanzillo Roberta⁵,Brescia Morra Vincenzo⁵,Nicoletti Carolina Gabri⁶,Landi Doriana⁶,Marfia Girolama⁶,Vercellino Marco⁷,Cavalla Paola⁷^ORCID,Bianco Assunta⁸,Mirabella Massimiliano⁸⁹^ORCID,Torri Clerici Valentina¹⁰,Tomas Eugenia¹⁰,Ferrò Maria Teresa¹¹,Grossi Paola¹¹,Nozzolillo Agostino¹²,Moiola Lucia¹²^ORCID,Zaffaroni Mauro¹³,Ronzoni Marco¹⁴,Pinardi Federica¹⁵,Novi Giovanni¹^ORCID,Cellerino Maria¹⁶,Uccelli Antonio¹¹⁶,Inglese Matilde¹¹⁶

Affiliation:

1. IRCCS Ospedale Policlinico San Martino, Genoa, Italy

2. Centro regionale per la diagnosi e la cura della Sclerosi Multipla, ASL Cagliari, Cagliari, Italy

3. Department of Medical Sciences and Public Health, Università degli studi di Cagliari, Cagliari, Italy

4. Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy

5. Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy

6. MS Center, Tor Vergata University of Rome, Rome, Italy

7. Division of Neurology, Department of Neuroscience and Mental Health, City of Health and Science, University Hospital of Torino, Turin, Italy

8. Multiple Sclerosis Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy

9. Centro di Ricerca per la Sclerosi Multipla “Anna Paola Batocchi,” Università Cattolica del Sacro Cuore, Rome, Italy

10. Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy

11. Neuroimmunology, Neurological Unit, Cerebrovascular Department, Center for Multiple Sclerosis, ASST Crema, Crema, Italy

12. Multiple Sclerosis Center, Neurology Department, IRCCS San Raffaele Hospital, Milan, Italy

13. Centro Sclerosi Multipla, Ospedale di Gallarate—ASST della Valle Olona, Gallarate, Italy

14. U.O. Neurologia, ASST Rhodense, Garbagnate Milanese, Italy

15. IRCCS Istituto delle scienze neurologiche di Bologna, UOSI Riabilitazione Sclerosi Multipla Bologna, Bologna, Italy

16. Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy

Abstract

Background: The reason why some multiple sclerosis (MS) patients show disease activity after alemtuzumab (ALM) is still unclear, but ocrelizumab (OCR) could represent an interesting sequential therapeutic approach. Objectives: To investigate safety and efficacy of OCR in MS patients with disease activity after two ALM courses. Methods: Observational retrospective multi-centers Italian cohort study. Results: Seventy-two subjects were included. Mean follow-up (FU) was 2.4 (±1) years. Forty-five patients (62.5%) experienced at least one adverse event (AE), with infections accounting for 96.7% of cases. A reduction in total lymphocytes was observed between OCR start and 6 months FU, driven by BCD19+ lymphocytes depletion ( p < 0.001). Immunoglobulin M (IgM) levels decreased between OCR start and 6 months FU ( p < 0.001). At 2-year FU, relapse, magnetic resonance imaging (MRI) activity and disability worsening-free survival were 92.1%, 90.8%, and 89.2%. The evidence of inflammatory activity between the two ALM courses was associated with higher risk of relapse, MRI activity, and NEDA-3 status loss in relapsing-remitting multiple sclerosis (RRMS; p = 0.02, p = 0.05, p = 0.01, respectively). Conclusions: OCR after two ALM courses seemed to be safe and effective. Early IgM hypogammaglobulinemia occurred in a high proportion of patients. The evidence of inflammatory activity between ALM courses seemed to increase the risk of MS re-activation on OCR treatment.

Funder

National Recovery and Resilience Plan

Fondazione Italiana Sclerosi Multipla

Ministero della Salute

Publisher

SAGE Publications

Link

https://journals.sagepub.com/doi/pdf/10.1177/13524585241266509

Reference40 articles.

1. Early Aggressive Treatment Approaches for Multiple Sclerosis

2. Long-term disability trajectories in relapsing multiple sclerosis patients treated with early intensive or escalation treatment strategies

3. Long-term Clinical Outcomes of Hematopoietic Stem Cell Transplantation in Multiple Sclerosis

4. Alemtuzumab: A Review in Relapsing Remitting Multiple Sclerosis

5. Alemtuzumab CARE-MS II 5-year follow-up