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Is It Time for Ocrelizumab Extended Interval Dosing in Relapsing Remitting MS? Evidence from An Italian Multicenter Experience During the COVID-19 Pandemic.
Zanghì, Aurora; Avolio, Carlo; Signoriello, Elisabetta; Abbadessa, Gianmarco; Cellerino, Maria; Ferraro, Diana; Messina, Christian; Barone, Stefania; Callari, Graziella; Tsantes, Elena; Sola, Patrizia; Valentino, Paola; Granella, Franco; Patti, Francesco; Lus, Giacomo; Bonavita, Simona; Inglese, Matilde; D'Amico, Emanuele.
  • Zanghì A; UOC Neurology, Sant'Elia Hospital, Caltanissetta, Italy.
  • Avolio C; Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
  • Signoriello E; Head of Multiple Sclerosis Center, Dept. of Neurosciences, Policlinico Riuniti Hospital, Foggia, Italy.
  • Abbadessa G; Multiple Sclerosis Center, II Division of Neurology, Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy.
  • Cellerino M; Dipartimento di Scienze Mediche e Chirurgiche Avanzate, Università della Campania Luigi Vanvitelli, Piazza Miraglia, 2, 80138, Naples, Italy.
  • Ferraro D; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (DINOGMI), University of Genoa, Genoa, Italy.
  • Messina C; University of Modena and Reggio Emilia, Modena, Italy.
  • Barone S; Department "G.F. Ingrassia", MS Center University of Catania, Catania, Italy.
  • Callari G; Azienda Ospedaliera Universitaria "Mater Domini", Catanzaro, Italy.
  • Tsantes E; Institute Foundation "G. Giglio", Cefalù, Italy.
  • Sola P; Department of General Medicine, Parma University Hospital, Parma, Italy.
  • Valentino P; University of Modena and Reggio Emilia, Modena, Italy.
  • Granella F; Azienda Ospedaliera Universitaria "Mater Domini", Catanzaro, Italy.
  • Patti F; Unit of Neurosciences, Department of Medicine and Surgery, University of Parma, Parma, Italy.
  • Lus G; Multiple Sclerosis Centre, Department of General Medicine, Parma University Hospital, Parma, Italy.
  • Bonavita S; Department "G.F. Ingrassia", MS Center University of Catania, Catania, Italy.
  • Inglese M; Multiple Sclerosis Center, II Division of Neurology, Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy.
  • D'Amico E; Dipartimento di Scienze Mediche e Chirurgiche Avanzate, Università della Campania Luigi Vanvitelli, Piazza Miraglia, 2, 80138, Naples, Italy.
Neurotherapeutics ; 19(5): 1535-1545, 2022 09.
Article in English | MEDLINE | ID: covidwho-2014575
ABSTRACT
In the COVID-19 pandemic era, safety concerns have been raised regarding the risk of severe infection following administration of ocrelizumab (OCR), a B-cell-depleting therapy. We enrolled all relapsing remitting multiple sclerosis (RRMS) patients who received maintenance doses of OCR from January 2020 to June 2021. Data were extracted in December 2021. Standard interval dosing (SID) was defined as a regular maintenance interval of OCR infusion every 6 months, whereas extended interval dosing (EID) was defined as an OCR infusion delay of at least 4 weeks. Three infusions were considered in defining SID vs. EID (infusions A, B, and C). Infusion A was the last infusion before January 2020. The primary study outcome was a comparison of disease activity during the A-C interval, which was defined as either clinical (new relapses) or radiological (new lesions on T1-gadolinium or T2-weighted magnetic resonance imaging (MRI) sequences). Second, we aimed to assess confirmed disability progression (CDP). A total cohort of 278 patients (174 on SID and 104 on EID) was enrolled. Patients who received OCR on EID had a longer disease duration and a higher rate of vaccination against severe acute respiratory syndrome-coronavirus 2 (p < 0.05). EID was associated with an increased risk of MRI activity during the A-C interval (OR 5.373, 95% CI 1.203-24.001, p = 0.028). Being on SID or EID did not influence CDP (V-Cramer 0.47, p = 0.342). EID seemed to be associated with a higher risk of MRI activity in our cohort. EID needs to be carefully considered for OCR-treated patients.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Sudden Infant Death / Multiple Sclerosis, Relapsing-Remitting / COVID-19 / Multiple Sclerosis Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines Limits: Humans Language: English Journal: Neurotherapeutics Journal subject: Neurology Year: 2022 Document Type: Article Affiliation country: S13311-022-01289-6

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Sudden Infant Death / Multiple Sclerosis, Relapsing-Remitting / COVID-19 / Multiple Sclerosis Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines Limits: Humans Language: English Journal: Neurotherapeutics Journal subject: Neurology Year: 2022 Document Type: Article Affiliation country: S13311-022-01289-6