Stable multiple sclerosis patients on anti-CD20 therapy should go on extended interval dosing: NO

Kempen, Zoé LE van; Hogenboom, Laura; Killestein, Joep

doi:10.1177/13524585211064441

Cited by 5 publications

(3 citation statements)

References 12 publications

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“…Similarly, encouraging findings were also obtained for another highly active drug (not acting on CD20), natalizumab [45]. However, the issue requires further study, especially since most of the available clinical data is from phase III trials with standard dosing, and there is relatively limited long-term data [46].…”

Section: Extended Interval Dosingmentioning

confidence: 85%

Targeting CD20 in multiple sclerosis — review of current treatment strategies

Chmielewska

Szyndler

2023

Neurol Neurochir Pol.

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Multiple sclerosis (MS) is a chronic autoimmune demyelinating disease of the central nervous system (CNS) that mostly manifests as irreversible disability. The aetiopathogenesis of MS is still unclear, although it was initially thought to be primarily mediated by T-cells.Research into the immune concepts of MS pathophysiology in recent years has led to a shift in the understanding of its origin i.e. from a T-cell-mediated to a B-cell-mediated molecular background. Thus, the use of B-cell-selective therapies, such as anti--CD20 antibody therapy, as expanded therapeutic options for MS is now strongly supported.This review provides an up-to-date discussion on the use of anti-CD20 targeted therapy in MS treatment. We present a rationale for its use and summarise the results of the main clinical trials showing the efficacy and safety of rituximab, ocrelizumab, ofatumumab, and ublituximab. Future directions that show selectivity to a broader population of lymphocytes, such as the use of anti-CD19 targeted antibodies, as well as the concept of extended interval dosing (EID) of anti-CD20 drugs, are also discussed in this review.

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Section: Extended Interval Dosingmentioning

confidence: 85%

Targeting CD20 in multiple sclerosis — review of current treatment strategies

Chmielewska

Szyndler

2023

Neurol Neurochir Pol.

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“…In light of the changes in disease-modifying treatment (DMT) practice during the COVID-19 pandemic, the “Controversies in Multiple Sclerosis” section of the April edition of Multiple Sclerosis Journal explores whether 6-monthly intervals between anti-CD20 infusions should be maintained or extended. Van Kempen et al 1 argue in favor and question the efficacy of extended interval dosing as the majority of the studies which have looked at extending infusion intervals are retrospective with short follow-up. On the contrary, Rolfes and Meuth 2 argue that the immunosuppressive effect of anti-CD20 extends beyond the 6-monthly intervals and that extending infusion intervals may offer an opportunity to reduce frequency of infusion and limit consequences of long-term immune suppression.…”

mentioning

confidence: 99%

Should anti-CD20 be used as an immune reconstitution therapy?

Smets¹,

Wokke²,

Smolders³

2022

Mult Scler

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“…5 On the "No" side, van Kempen and Killestein argue that despite some of the positive data regarding retained efficacy in EID, the studies are mostly retrospective with short follow-up periods. 6 On the contrary, they argue that higher drug concentrations of ocrelizumab, for example, have been associated with reduced risk of confirmed disability seen in earlier ocrelizumab trials leading to the on-going head-tohead studies that are looking at escalating doses for patient with higher weight. journals.sagepub.com/home/msj Both authors do not take for granted the presumed benefit of reduced infections in EID and quote the many observational data regarding risk of COVID-19 in these patients.…”

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confidence: 99%