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Switch to ocrelizumab in MS patients treated with natalizumab in extended interval dosing at high risk of PML: A 96-week follow-up pilot study

We aimed to assess the long-term safety and effectiveness of ocrelizumab in a cohort of patients with multiple sclerosis (MS) at high risk of progressive multifocal leukoencephalopathy (PML), previously treated with natalizumab in extending interval dosing (EID), who switched to ocrelizumab and to c...

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Autores principales: Santiago-Setien, Pilar, Barquín-Rego, Cristina, Hernández-Martínez, Paula, Ezquerra-Marigomez, María, Torres-Barquin, Marta, Menéndez-Garcia, Cristina, Uriarte, Fernando, Jiménez-López, Yésica, Misiego, Mercedes, Sánchez de la Torre, Jose Ramón, Setien, Sonia, Delgado-Alvarado, Manuel, Riancho, Javier
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9929864/
https://www.ncbi.nlm.nih.gov/pubmed/36817456
http://dx.doi.org/10.3389/fimmu.2023.1086028
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author Santiago-Setien, Pilar
Barquín-Rego, Cristina
Hernández-Martínez, Paula
Ezquerra-Marigomez, María
Torres-Barquin, Marta
Menéndez-Garcia, Cristina
Uriarte, Fernando
Jiménez-López, Yésica
Misiego, Mercedes
Sánchez de la Torre, Jose Ramón
Setien, Sonia
Delgado-Alvarado, Manuel
Riancho, Javier
author_facet Santiago-Setien, Pilar
Barquín-Rego, Cristina
Hernández-Martínez, Paula
Ezquerra-Marigomez, María
Torres-Barquin, Marta
Menéndez-Garcia, Cristina
Uriarte, Fernando
Jiménez-López, Yésica
Misiego, Mercedes
Sánchez de la Torre, Jose Ramón
Setien, Sonia
Delgado-Alvarado, Manuel
Riancho, Javier
author_sort Santiago-Setien, Pilar
collection PubMed
description We aimed to assess the long-term safety and effectiveness of ocrelizumab in a cohort of patients with multiple sclerosis (MS) at high risk of progressive multifocal leukoencephalopathy (PML), previously treated with natalizumab in extending interval dosing (EID), who switched to ocrelizumab and to compare them with patients who continued EID-natalizumab. Thirty MS patients previously treated with natalizumab in EID (every 8 weeks) were included in this observational retrospective cohort study. Among them, 17 patients were switched to ocrelizumab and 13 continued with EID-natalizumab. Except for the John Cunningham virus (JCV) index, no significant differences were detected between both groups. Main outcome measures included: annualized relapse rate (ARR), radiological activity, disability progression, and the NEDA-3 index. Patients were followed for 96 weeks. The median washout period in ocrelizumab-switchers was 6 weeks. Among them, AAR and radiological activity during follow-up were 0.03, without significant differences in comparison with the previous period on natalizumab-EID. The comparison between ocrelizumab-switchers and patients continuing on EID-natalizumab showed no significant differences in AAR, radiological activity, or disability progression. However, the proportion of patients maintaining a NEDA-3 status in week 96 was slightly superior among ocrelizumab-switchers (94 vs 69%). No serious adverse events were observed in any group. In conclusion, switching from EID-natalizumab to ocrelizumab can be considered as a therapeutic option, particularly in patients with MS at high risk of PML, to mitigate the risks of both PML and disease reactivation.
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spelling pubmed-99298642023-02-16 Switch to ocrelizumab in MS patients treated with natalizumab in extended interval dosing at high risk of PML: A 96-week follow-up pilot study Santiago-Setien, Pilar Barquín-Rego, Cristina Hernández-Martínez, Paula Ezquerra-Marigomez, María Torres-Barquin, Marta Menéndez-Garcia, Cristina Uriarte, Fernando Jiménez-López, Yésica Misiego, Mercedes Sánchez de la Torre, Jose Ramón Setien, Sonia Delgado-Alvarado, Manuel Riancho, Javier Front Immunol Immunology We aimed to assess the long-term safety and effectiveness of ocrelizumab in a cohort of patients with multiple sclerosis (MS) at high risk of progressive multifocal leukoencephalopathy (PML), previously treated with natalizumab in extending interval dosing (EID), who switched to ocrelizumab and to compare them with patients who continued EID-natalizumab. Thirty MS patients previously treated with natalizumab in EID (every 8 weeks) were included in this observational retrospective cohort study. Among them, 17 patients were switched to ocrelizumab and 13 continued with EID-natalizumab. Except for the John Cunningham virus (JCV) index, no significant differences were detected between both groups. Main outcome measures included: annualized relapse rate (ARR), radiological activity, disability progression, and the NEDA-3 index. Patients were followed for 96 weeks. The median washout period in ocrelizumab-switchers was 6 weeks. Among them, AAR and radiological activity during follow-up were 0.03, without significant differences in comparison with the previous period on natalizumab-EID. The comparison between ocrelizumab-switchers and patients continuing on EID-natalizumab showed no significant differences in AAR, radiological activity, or disability progression. However, the proportion of patients maintaining a NEDA-3 status in week 96 was slightly superior among ocrelizumab-switchers (94 vs 69%). No serious adverse events were observed in any group. In conclusion, switching from EID-natalizumab to ocrelizumab can be considered as a therapeutic option, particularly in patients with MS at high risk of PML, to mitigate the risks of both PML and disease reactivation. Frontiers Media S.A. 2023-02-01 /pmc/articles/PMC9929864/ /pubmed/36817456 http://dx.doi.org/10.3389/fimmu.2023.1086028 Text en Copyright © 2023 Santiago-Setien, Barquín-Rego, Hernández-Martínez, Ezquerra-Marigomez, Torres-Barquin, Menéndez-Garcia, Uriarte, Jiménez-López, Misiego, Sánchez de la Torre, Setien, Delgado-Alvarado and Riancho https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Santiago-Setien, Pilar
Barquín-Rego, Cristina
Hernández-Martínez, Paula
Ezquerra-Marigomez, María
Torres-Barquin, Marta
Menéndez-Garcia, Cristina
Uriarte, Fernando
Jiménez-López, Yésica
Misiego, Mercedes
Sánchez de la Torre, Jose Ramón
Setien, Sonia
Delgado-Alvarado, Manuel
Riancho, Javier
Switch to ocrelizumab in MS patients treated with natalizumab in extended interval dosing at high risk of PML: A 96-week follow-up pilot study
title Switch to ocrelizumab in MS patients treated with natalizumab in extended interval dosing at high risk of PML: A 96-week follow-up pilot study
title_full Switch to ocrelizumab in MS patients treated with natalizumab in extended interval dosing at high risk of PML: A 96-week follow-up pilot study
title_fullStr Switch to ocrelizumab in MS patients treated with natalizumab in extended interval dosing at high risk of PML: A 96-week follow-up pilot study
title_full_unstemmed Switch to ocrelizumab in MS patients treated with natalizumab in extended interval dosing at high risk of PML: A 96-week follow-up pilot study
title_short Switch to ocrelizumab in MS patients treated with natalizumab in extended interval dosing at high risk of PML: A 96-week follow-up pilot study
title_sort switch to ocrelizumab in ms patients treated with natalizumab in extended interval dosing at high risk of pml: a 96-week follow-up pilot study
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9929864/
https://www.ncbi.nlm.nih.gov/pubmed/36817456
http://dx.doi.org/10.3389/fimmu.2023.1086028
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