The wearing-off phenomenon of ocrelizumab in patients with multiple sclerosis

Toorop, Alyssa A; Lierop, Zoë Y. G. J. van; Strijbis, Eva; Teunissen, C.E.; Barkhof, Frederik; Uitdehaag, Bernard M. J.; Kempen, Zoé L E van; Killestein, Joep

doi:10.1016/j.msard.2021.103364

Cited by 11 publications

(14 citation statements)

References 21 publications

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“…A recent study showed that 61% of MS patients on ocrelizumab experienced this phenomenon during treatment. 8 Even though the wearing-off phenomenon in this cohort was not predicted by infusion intervals, EID could increase duration or severity of these symptoms in a proportion of patients.…”

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confidence: 64%

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

2022

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mentioning

confidence: 64%

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

2022

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“…Full text articles were available for 23 (44%) of the studies, while only conference abstracts were available for the remainder. Studies varied widely by geographical region; 33 reported real‐world outcomes in Europe, 7–39 seven in the United States, 40–46 two in the Middle East, 47,48 three in various geographical regions, 49–51 one in South America, 52 and six did not report the country in which the study was conducted 53–58 . The most frequently reported study populations included combined populations of RRMS, PPMS, and SPMS patients for which data were not stratified by type of MS ( n = 20).…”

Section: Resultsmentioning

confidence: 99%

“…Six studies assessed time to first relapse in patients treated with ocrelizumab, with patient numbers ranging from 33 to 1104 8,18,28,34,39,51,58 (Table S5). Median time to first relapse following treatment initiation with ocrelizumab ranged from 52.5 days (411 RRMS patients switching to ocrelizumab following fingolimod treatment) 51 to 8.7 months (66 RRMS and PPMS patients switching to ocrelizumab following natalizumab treatment) 58 .…”

Section: Resultsmentioning

confidence: 99%

“…59 Two studies performed statistical analysis of relapse data between RRMS patients receiving different disease-modifying therapies (DMTs) and both reported significantly fewer relapses in ocrelizumabtreated patients. 8,39 Time to relapse Six studies assessed time to first relapse in patients treated with ocrelizumab, with patient numbers ranging from 33 to 1104 8,18,28,34,39,51,58 (Table S5). Median time to first relapse following treatment initiation with ocrelizumab ranged from 52.5 days (411 RRMS patients switching to ocrelizumab following fingolimod treatment) 51 to 8.7 months (66 RRMS and PPMS patients switching to ocrelizumab following natalizumab treatment).…”

Section: Clinical Relapsementioning

confidence: 99%

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Real‐world evaluation of ocrelizumab in multiple sclerosis: A systematic review

Montalbán¹,

Matthews

Simpson

et al. 2023

Ann Clin Transl Neurol

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Across its clinical development program, ocrelizumab demonstrated efficacy in improving clinical outcomes in multiple sclerosis, including annualized relapse rates and confirmed disability progression. However, as with any new treatment, it was unclear how this efficacy would translate into real‐world clinical practice. The objective of this study was to systematically collate the published real‐world clinical effectiveness data for ocrelizumab in relapsing remitting multiple sclerosis and primary progressive multiple sclerosis. A search strategy was developed in MEDLINE and Embase to identify articles reporting real‐world evidence in people with relapsing remitting multiple sclerosis or primary progressive multiple sclerosis receiving treatment with ocrelizumab. The search focused on English language articles only but was not limited by the country in which the study was conducted or the time frame of the study. Additional manual searches of relevant websites were also performed. Fifty‐two studies were identified reporting relevant evidence. Real‐world effectiveness data for ocrelizumab were consistently favorable, with reductions in relapse rate and disease progression rates similar to those reported in the OPERA I/OPERA II and ORATORIO clinical trials, including in studies with more diverse patient populations not well represented in the pivotal trials. Although direct comparisons are confounded by lack of randomization of treatments, outcomes reported suggest that ocrelizumab has a similar or greater efficacy than other therapy options. Initial real‐world effectiveness data for ocrelizumab appear favorable and consistent with results reported in clinical trials, providing clinicians with an efficacious option to treat patients with multiple sclerosis.

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“…This phenomenon has previously been recognized and studied in natalizumab and ocrelizumab. 3 , 4 The reasons behind the wearing-off phenomenon are incompletely understood, particularly in agents such as rituximab and ocrelizumab, in which B-cell repopulation rarely occurs prior to the 6 month dosing interval 5 and B-cell depletion can be verified through laboratory testing. In natalizumab-treated patients, the wearing-off phenomenon has been associated with lower occupancy rates of the alpha 4-integrin receptor on circulating leukocytes.…”

Section: Introductionmentioning

confidence: 99%

The patient-reported wearing-off phenomenon with monoclonal antibody treatments for multiple sclerosis

Marian,

Harris,

Conway

2024

Multiple Sclerosis Journal - Experimental, Translational and Cl

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Background Many patients report a wearing-off phenomenon with monoclonal antibody treatment for multiple sclerosis in which perceived benefits wear off before the next dose is due. Objectives To determine prevalence of the wearing-off effect, symptoms experienced, impact on treatment satisfaction, and associated patient characteristics. Methods Patients receiving natalizumab, ocrelizumab, ofatumumab, or rituximab at a tertiary multiple sclerosis center were invited to take an online survey interrogating their monoclonal antibody experience. Additional history and patient characteristic data were collected. Logistic regression was used to determine if patient characteristics predicted the wearing-off effect and linear regression to evaluate the impact of the wearing-off effect on treatment satisfaction. The models were adjusted for age, disease duration, race, sex, body mass index, education, and depression as measured by the Patient Health Questionnaire-9. Results We received 258 qualifying responses and 141 (54.7%) patients reported the wearing-off phenomenon. The most common symptom was fatigue (47.7%). Higher Patient Health Questionnaire-9 scores were significantly associated with the wearing-off phenomenon (OR = 1.02, p = 0.005). The wearing-off effect (β = −0.52, p = 0.04) and higher Patient Health Questionnaire-9 (β = −0.09, p < 0.01) scores were associated with significantly reduced treatment satisfaction. Conclusion The wearing-off phenomenon is common, associated with depression, and reduces treatment satisfaction. Research addressing mitigation strategies is needed.

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The wearing-off phenomenon of ocrelizumab in patients with multiple sclerosis

Cited by 11 publications

References 21 publications

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

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

Real‐world evaluation of ocrelizumab in multiple sclerosis: A systematic review

The patient-reported wearing-off phenomenon with monoclonal antibody treatments for multiple sclerosis

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