1. Personalizing ocrelizumab treatment in Multiple Sclerosis: What can we learn from Sars-Cov2 pandemic?
- Author
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Tazza, F., Lapucci, C., Cellerino, M., Boffa, G., Novi, G., Poire, I., Mancuso, E., Bruschi, N., Sbragia, E., Laroni, A., Capello, E., and Inglese, M.
- Subjects
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SARS-CoV-2 , *MULTIPLE sclerosis , *COVID-19 pandemic , *VACCINE effectiveness , *PANDEMICS - Abstract
During SARS-CoV-2 pandemic, we adopted a personalized delayed protocol for ocrelizumab infusions in Relapsing Remitting Multiple Sclerosis (RRMS) patients according to the national recommendations. Out of the 83 RRMS patients whose infusion was scheduled between March and December 2020, 56 patients experienced a delay in treatment based on MS severity and SARS-CoV2 infection risk profile. In most cases, the immunophenotype was performed monthly to guide re-infusions. Specifically, B CD19 + cells repopulation rate was monitored. Mean infusion delay was 103,1 [SD 40,6] days, and none of the patients presented relapses or active disease at MRI at the end of the observation period. Treatment naïve status and the interval between immunophenotyping and the last ocrelizumab infusion were predictors of earlier B CD19 + cells repopulation. Two patients contracted SARS-CoV2 with complete recovery. Definitive data about Sars-Cov2 vaccine efficacy in patients treated with ocrelizumab are still lacking. Our findings suggest that a personalized treatment with a delayed infusion schedule does not compromise ocrelizumab short-term efficacy and may help to lengthen the therapeutic window for an effective response to SARS-CoV2 vaccine. • Brief postponing of Ocrelizumab infusions appears to not impact on short-term efficacy and safety outcomes. • CD19+ cells monitoring may guide re-infusion in RRMS patients, preserving treatment efficacy against inflammatory activity. • Treatment naïve RRMS patients seems to present a faster repopulation rate in comparison with previously treated RRMS patients. • A positive correlation was found between CD19+ cells repopulation rate and the time interval from last ocrelizumab infusion. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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