Ocrelizumab-induced alopecia areata—A series of five patients from Ontario, Canada: A case report

Chin, Laura D.; AbuHilal, Mohn’d

doi:10.1177/2050313x20919614

Cited by 11 publications

(10 citation statements)

References 20 publications

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“…Finally, six cases of alopecia were observed, a side effect not reported in the OPERA studies. As another recent study reported five patients developing alopecia following ocrelizumab initiation [24], further research into this aspect is warranted.…”

Section: Discussionmentioning

confidence: 99%

Ocrelizumab treatment in multiple sclerosis: A Danish population‐based cohort study

Pontieri

Blinkenberg

Bramow

et al. 2021

Euro J of Neurology

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Background and purpose Real‐world evidence regarding the effectiveness and safety of ocrelizumab for the treatment of multiple sclerosis (MS) is limited. The aim was to evaluate the effectiveness and safety of ocrelizumab treatment for MS in a real‐world setting. Methods A nationwide population‐based cohort study was conducted where clinical and magnetic resonance imaging data of MS patients enrolled prospectively in the Danish Multiple Sclerosis Registry who initiated ocrelizumab treatment between January 2018 and November 2020 were analyzed. Results A total of 1104 patients (85.7% relapsing–remitting MS [RRMS], 8.8% secondary progressive MS [SPMS], 5.5% primary progressive MS [PPMS]) were included, with a median follow‐up period of 1.3 years. At baseline, the mean age was 41.4 years in the RRMS group, 44.5 years in the PPMS group and 50.3 years in the SPMS group. Median Expanded Disability Status Scale score was 2.5, 3.5 and 5.5, respectively. Most RRMS and SPMS patients had received previous disease‐modifying therapies (87.5% and 91.8%, respectively), whereas PPMS patients were mostly treatment naïve (78.7%). After ocrelizumab initiation, 9.3% of the patients experienced a relapse and 8.7% a 24 weeks confirmed disability worsening. Conversely, 16.7% showed a 24 weeks confirmed disability improvement. After ~1 year of treatment, most patients (94.5%) were free of magnetic resonance imaging activity. Ocrelizumab was generally well tolerated, as side effects were only reported for 10% of patients, mostly consisting of infusion‐related reactions and infections. Conclusions It is shown that most MS patients treated with ocrelizumab are clinically stabilized and with an adverse event profile consistent with the experience from the pivotal clinical trials.

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Section: Discussionmentioning

confidence: 99%

Ocrelizumab treatment in multiple sclerosis: A Danish population‐based cohort study

Pontieri

Blinkenberg

Bramow

et al. 2021

Euro J of Neurology

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“…Es gibt jedoch auch Fallberichte über das erstmalige Auftreten einer AA unter der Therapie mit Dupilumab [156,157]. Interessanterweise stehen auch die monoklonalen Antikörper Alemtuzumab und Ocrelizumab im Verdacht, eine AA bei Patienten auszulösen, die aufgrund multipler Sklerose behandelt werden [158,159].…”

Section: Weitere Systemische Behandlungenunclassified

Alopecia areata – Aktuelles Verständnis und Management

Lintzeri

Constantinou

Hillmann

et al. 2022

J Deutsche Derma Gesell

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Die Alopecia areata (AA) ist eine chronische immunvermittelte Erkrankung, die durch akuten oder chronischen, nicht vernarbenden Haarausfall gekennzeichnet ist. Die klinischen Erscheinungsformen sind sehr unterschiedlich und reichen von kleinen umschriebenen haarlosen Stellen bis hin zum vollständigen Verlust der Kopf-und Körperbehaarung. Diese Übersicht soll aktuelles Wissen zu Pathophysiologie und beteiligten Signalwegen vermitteln sowie diagnostische und therapeutische Empfehlungen geben. Aktuell verfügbare Therapieansätze bei AA, einschließlich topischer, systemischer und injizierbarer Interventionen, zeigen unterschiedlich gutes Ansprechen mit häufigen Rezidiven, was den dringenden Bedarf an effektiven zielgerichteten Therapien widerspiegelt. Neue therapeutische Ansätze und Konzepte, einschließlich Januskinase-Inhibitoren, werden mit großer Spannung erwartet. Diese Übersicht diskutiert traditionelle und neue Therapieansätze für das Management der AA. Diese Erkrankung führt häufig zu einer starken psychosozialen Belastung für die Betroffenen, kann zu Depressionen führen, Angstzustände auslösen und die Lebensqualität beeinträchtigen. Daher sollten psychosoziale Aspekte der Krankheit mit berücksichtigt, beim Patienten angesprochen und die Notwendigkeit einer psychologischen Unterstützung erwogen werden.

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“…Previously, 6 reports of alopecia areata following ocrelizumab therapy have been reported. 46,47 We found 243 reports, mostly in 2019, suggesting a possible association. Additionally, there were increased odds in female patients.…”

Section: Ocrelizumabmentioning

confidence: 84%

Alopecia in Multiple Sclerosis Patients Treated with Disease Modifying Therapies

Porwal

Salter

Patel

et al. 2022

J Cent Nerv Syst Dis

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BACKGROUND There is currently limited literature addressing the reporting of alopecia in multiple sclerosis (MS) patients treated with disease-modifying therapies (DMTs). Anecdotal reports of hair thinning from patients on various DMTs prompted further investigation of a large database. OBJECTIVE To analyze total reports, source of reporting, age distribution, and sex distribution of alopecia associated with DMTs. METHODS FDA Adverse Event Reporting System (FAERS) public dashboard and OpenFDA database were analyzed for alopecia reports between January 1, 2009, and June 30, 2020, attributed to usage in MS of FDA approved DMTs. The main outcomes included total reports for each drug, age, sex distribution, and reporting source. OpenFDA data was used for statistical analyses including reporting odds ratios (ROR) and information components. RESULTS 8759 alopecia reports were identified among 44 114 adverse events in skin and subcutaneous tissue disorders (19.9%). 3701 (42.3%) with teriflunomide, 1675 (19.1%) with dimethyl fumarate, 985 (11.2%) with natalizumab, 926 (10.6%) with fingolimod, 659 (7.5%) with interferon beta-1a, 257 (2.9%) with glatiramer acetate, 243 (2.8%) with ocrelizumab, 124 (1.4%) with interferon beta-1b, 117 (1.3%) with alemtuzumab, 36 (.4%) with siponimod, 24 (.3%) with cladribine, and 12 (.1%) with rituximab. Reports were mostly made by patients (78.3%) and highest in fifth and sixth decades of life. OpenFDA analyses showed increased ROR (ROR 95% confidence interval) of alopecia in females with teriflunomide (18.00, 17.12-18.93), alemtuzumab (1.43, 1.16-1.76), dimethyl fumarate (1.26, 1.18-1.34), and ocrelizumab (1.28, 1.11-1.49). Increased ROR in males was associated with teriflunomide (24.65, 20.72-29.31). CONCLUSION We identified many reports of alopecia for DMTs in addition to teriflunomide. Within the limitations of the database, increased RORs of alopecia were observed for females treated with alemtuzumab, dimethyl fumarate, and ocrelizumab. The source of reporting was largely driven by female patients. Possible alopecia, even if transient, should be considered during patient education when starting DMTs.

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Ocrelizumab-induced alopecia areata—A series of five patients from Ontario, Canada: A case report

Cited by 11 publications

References 20 publications

Ocrelizumab treatment in multiple sclerosis: A Danish population‐based cohort study

Ocrelizumab treatment in multiple sclerosis: A Danish population‐based cohort study

Alopecia areata – Aktuelles Verständnis und Management

Alopecia in Multiple Sclerosis Patients Treated with Disease Modifying Therapies

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