ABSTRACT
Background: During COVID-19 pandemic second line disease modifying therapies (DMTs) for multiple sclerosis (MS), have been frequently postponed because of the epidemiological situation and the lack of safety information. Objective(s): To evaluate clinical implications of delaying ocrelizumab dosing in MS. Aim(s): To assess the occurrence of clinical relapses, disability worsening and neuroradiological disease activity in MS patients receiving extended interval dosing ocrelizumab in a real-world setting. Method(s): Data from 90 MS patients (65 RRMS, 25 PPMS) who underwent ocrelizumab dose delay have been retrospectively obtained: in particular MS history, neurological examinations, white blood cells count (particularly lymphocyte subsets) and neuroradiological data have been collected. Result(s): Enrolled patients have been followed up for a mean of 9.5+/-2.8 months after ocrelizumab dose delay (mean dosing interval 7.67+/-0.79 months). None of our 65 RRMS patients had clinical relapses, nor rapid disability worsening has been experienced by the PPMS cohort. Pre-infusion CD19+/CD20+ lymphocyte subset was available in 75/90 patients, with 18/75 patients showing significant B cells repopulation (defined as CD19+/CD20+ >= 1.0%). MRI data were available in 47/90 patients, with 5/47 patients showing evidence of neuroradiological disease activity (mild in all reported cases and in the absence of any correlation with B cells repopulation). Conclusion(s): Our data suggest ocrelizumab dose delay is generally safe in MS patients. Experiences during COVID-19 pandemic could be a starting point towards a more personalized scheduling of ocrelizumab therapy.