Real-world experience of ocrelizumab in MS in the Turkish population: A singlecenter study

Background and aims: Ocrelizumab is a humanized monoclonal antibody effective against CD20 positive B cells, approved by the FDA in 2017 to treat RRMS and PPMS. Despite these clinical studies, real-life data on ocrelizumab are limited. Methods: We conducted a retrospective single-center study in Turkey. We obtained medical record data of patients who received at least one infusion of ocrelizumab and were followed for one year before and after treatment initiation. Results: 240 MS patients were included in our study (58.75%) RRMS, (21.25%) SPMS, and (20%) PPMS). Median follow-up was14 months (range, 4-42). 92% of all patients received another DMT or immunosuppressant (98.58% of RRMS, 100% of SPMS, 64.58% of PPMS) prior to treatment with ocrelizumab. ARR before and after initiation of ocrelizumab for both the RRMS and SPMS groups (RRMS, 0.8 vs. 0.1;SPMS, 0.44 vs. 0.04). The most common reason for switching to ocrelizumab was clinical and/or radiological activity. NEDA status at year one was achieved in 88.54% of the RRMS population, and disability progression was found at 12.77% in the same MS subtype. Despite premedication (97.91%), infusion-related reactions were reported in (15.41%). The most common infection in our study was COVID-19 infection (18.33%), followed by urinary and upper respiratory tract infections. Conclusion: According to the first real-world preliminary study in the Turkish MS population using ocrelizumab, it is a well-tolerated, safe, and effective treatment agent in suppressing disease activity in both RRMS and progressive MS forms.

A postgraduate training program for early career psychiatrists serving patients with bipolar disorder

Introduction: Beyond a significant psychological burden in lives of patients with bipolar disorders, the COVID-19 outbreak created a significant obstacle in accessibility to mental health services, which raised a need for a country-wide network of healthcare providers for bipolar disorders in Turkey. The Bipolar Disorders Chapter of Turkey organized a training program for excellence in diagnosis and management of bipolar disorders in order to train early career psychiatrists who carry out mental services all over the country. Method: We announced a training program consisting of four modules including interactive Zoom lessons giving the theoretical baseline 48 hours), and a supervision module that includes case discussions with experts (96 hours). The lectures and discussions were moderated by leading specialists in bipolar disorders in Turkey. The theoretical modules focused on diagnosis and classification, pharmacological treatment, psychosocial interventions, and special populations (elders, pregnants, patients with comorbidity etc.) in bipolar disorders. Results: We trained 40 early career psychiatrists (14 men, 26 women;between ages of 27-40) from 18 different cities of Turkey. 37 of them have successfully completed the four modules, passed the final examination, and qualified for the supervision module. Most participants agreed that the program enhanced their clinical skills perfectly (satisfaction over 90%). Conclusion: This might be a good example of a postgraduate training program for clinicians serving patients with bipolar disorders. Such training programs might create a basis for building country-wide networks of healthcare professionals for bipolar disorders.