Hemophagocytic lymphohistiocytosis associated with ocrelizumab treatment in a patient with multiple sclerosis

Machlańska, Agnieszka; Helbig, Grzegorz; Chromik, Karolina; Zapała, Magdalena; Zwiernik, Bartosz; Selmaj, Krzysztof

doi:10.1177/1352458521993070

Cited by 4 publications

(1 citation statement)

References 10 publications

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“…Moreover, due to the inclusion of a highly selected population, adverse events might be also underestimated in pivotal trials [13,14]. Since the positioning of ocrelizumab is still not well established within the therapeutic algorithm for MS, it is crucial to provide clinicians with relevant information on prognostic and predictive factors that can help assess the benefit-risk ratio.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Ocrelizumab Effectiveness in Patients with Multiple Sclerosis

et al. 2021

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SummaryData regarding effectiveness and safety of ocrelizumab in the post-marking setting are lacking. The aim of our study was to provide effectiveness and safety data of ocrelizumab treatment in patients with relapsing–remitting (RR-) and progressive multiple sclerosis (PMS) and to evaluate clinical and immunological predictors of early treatment response. In this single-center prospective observational study, we investigated effectiveness outcomes (time-to-confirmed disability worsening, time-to-first relapse, time-to-first evidence of MRI activity and time-to-first evidence of disease activity), clinical and immunological predictors of early treatment response, and incidence of adverse events (AEs). One hundred and fifty-three subjects were included (93 RRMS; 84 females). Median follow-up was 1.9 (1.3–2.7). At 2-year follow-up (FU), disability worsening-free survival were 90.5%, 64.7%, and 68.8% for RRMS, primary-progressive MS (PPMS), and secondary-progressive MS (SPMS) patients, respectively. At 2-year FU, 67.1%, 72.7%, and 81.3% of patients with RRMS, PPMS, and SPMS were free of MRI activity, with NEDA-3 percentages of 62.1%, 54.6%, and 55.1%, respectively. Lower baseline EDSS was independently associated with a reduced risk of disability worsening (HR(95%CI) = 1.45(1.05–2.00), p = 0.024) and previous treatment exposure was independently associated with increased probability of radiological activity (HR = 2.53(1.05–6.10), p = 0.039). At 6-month FU, CD8 + cell decrease was less pronounced in patients with inflammatory activity (p = 0.022). Six patients (3.9%) discontinued ocrelizumab due to severe AEs. Our findings suggest that ocrelizumab is an effective treatment in real-world patients with RRMS and PMS, with a manageable safety profile. Better outcomes were observed in treatment-naïve patients and in patients with a low baseline disability level. Depletion of CD8 + cells could underlie early therapeutic effects of ocrelizumab.

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Section: Introductionmentioning

confidence: 99%

Predictors of Ocrelizumab Effectiveness in Patients with Multiple Sclerosis

et al. 2021

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Ocrelizumab

2021

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Neoehrlichiosis associated with ocrelizumab in a patient with multiple sclerosis: A case report

Afzal,

Romme Christensen,

Gynthersen

et al. 2024

Mult Scler

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Objective: To describe a case of neoehrlichiosis, an emerging opportunistic tick-borne infection, in a patient with multiple sclerosis (MS) treated with ocrelizumab. Methods: This is a case study. Results: Our patient developed clinical infection over several months while on ocrelizumab and was ultimately diagnosed with neoehrlichiosis, caused by the bacteria Neoehrlichia mikurensis. Resolution of symptoms began within a few days after the initiation of antibiotic treatment. Conclusion: We describe the first probable case of ocrelizumab-associated neoehrlichiosis in a patient with MS. Clinicians should be aware of this potentially debilitating and life-threatening infection in patients receiving CD20-depleting therapy.

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Hemophagocytic lymphohistiocytosis associated with ocrelizumab treatment in a patient with multiple sclerosis

Cited by 4 publications

References 10 publications

Predictors of Ocrelizumab Effectiveness in Patients with Multiple Sclerosis

Predictors of Ocrelizumab Effectiveness in Patients with Multiple Sclerosis

Ocrelizumab

Neoehrlichiosis associated with ocrelizumab in a patient with multiple sclerosis: A case report

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