Personalized B-cell tailored dosing of ocrelizumab in patients with multiple sclerosis during the COVID-19 pandemic
Zoë YGJ van Lierop, Alyssa A Toorop, Wouter JC van Ballegoij, Tom BG Olde Dubbelink, Eva Strijbis, Brigit A. de Jong, Bob W. van Oosten, Bastiaan Moraal, Charlotte E. Teunissen, Bernard M.J. Uitdehaag, Joep Killestein, Zoé L. E. van Kempen
Abstract
In this observational study, 159 patients with multiple sclerosis received personalized dosing of ocrelizumab incentivized by the COVID-19 pandemic. Re-dosing was scheduled when CD19 B-cell count was ⩾10 cells/µL (starting 24 weeks after the previous dose, repeated 4-weekly). Median interval until re-dosing or last B-cell count was 34 [30-38] weeks. No clinical relapses were reported and a minority of patients showed Expanded Disability Status Scale (EDSS) progression. Monthly serum neurofilament light levels remained stable during extended intervals. Two (1.9%) of 107 patients with a follow-up magnetic resonance imaging (MRI) scan showed radiological disease activity. Personalized dosing of ocrelizumab could significantly extend intervals with low short-term disease activity incidence, encouraging future research on long-term safety and efficacy.