期刊
MULTIPLE SCLEROSIS AND RELATED DISORDERS
卷 57, 期 -, 页码 -出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.msard.2021.103448
关键词
Multiple sclerosis; Ocrelizumab; Rituximab; CD20; Alemtuzumab; Cladribine
Ocrelizumab differs from other treatments in its inhibitory effect on seroconversion, potentially resulting in delayed repletion of B cells within 3 months. Controlled studies are necessary to explore whether delaying the dosing interval by 3-6 months post-vaccination may increase the potential for seroconversion.
Background: Ocrelizumab maintains B-cell depletion via six-monthly dosing. Whilst this controls relapsing multiple sclerosis, it also inhibits seroconversion following SARS-CoV-2 vaccination unlike that seen following alemtuzumab and cladribine treatment. Emerging reports suggest that 1-3% B-cell repopulation facilitates seroconversion after CD20-depletion. Objective: To determine the frequency of B-cell repopulation levels during and after ocrelizumab treatment. Methods: Relapse data, lymphocyte and CD19 B-cell numbers were obtained following requests to clinical trial data-repositories. Information was extracted from the phase II ocrelizumab extension (NCT00676715) trial and the phase III cladribine tablet (NCT00213135) and alemtuzumab (NCT00530348/NCT00548405) trials obtained clinical trial data requests Results: Only 3-5% of people with MS exhibit 1% B-cells at 6 months after the last infusion following 3-4 cycles of ocrelizumab, compared to 50-55% at 9 months, and 85-90% at 12 months. During this time relapses occurred at consistent disease-breakthrough rates compared to people during standard therapy. In contrast most people (90-100%) exhibited more than 1% B-cells during treatment with either cladribine or alemtuzumab. Conclusions: Most people demonstrate B cell repletion within 3 months of the last treatment of alemtuzumab and cladribine. However, few people repopulate peripheral B-cells with standard ocrelizumab dosing. Controlled studies are warranted to examine a view that delaying the dosing interval by 3-6 months may allow more people to potentially seroconvert after vaccination.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据