African American Patients With MS Switch to Ocrelizumab Treatment Earlier than Caucasian Patients


Researchers also found that patients with progressive MS had longer disease duration before starting DMTs than those with relapsing MS.

 Alana Jones, MD-PhD graduate student, University of Alabama at Birmingham

A recent study clarified characteristics of patients with multiple sclerosis (MS) receiving ocrelizumab (Ocrevus; Genentech) treatment among varying demographic groups.

The study was presented by Olga Manouvakhova, University of Alabama at Birmingham, and colleagues at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2021, February 25-27.

“Ocrelizumab is a recombinant human anti-CD20 monoclonal antibody, which causes B-cells depletion and is approved for treatment of primary progressive multiple sclerosis (PPMS) and relapsing MS (RMS). Since approval in 2017, over 100,000 MS patients have been treated with ocrelizumab,” Manouvakhova and colleagues wrote.

The researchers conducted a retrospective chart review at a large tertiary referral MS Center in order to understand the rationale for use of ocrelizumab in patients with PPMS and RMS, as well as patient reasons for switching from other disease modifying therapies (DMTs), as a majority had done so. 

Manouvakhova and colleagues analyzed data from the 252 patients seen at the University of Alabama at Birmingham MS Center that were treated with ocrelizumab through January 2020. Of these patients, 158 (63%) had RMS, 94 (37%) had PPMS, and 53 (21%) were treatment naïve. Patients were mostly female (n = 176; 70.2%); 35 (67.5%) were Caucasian and 80 (31.7%) were African American (AA).

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Patients with PPMS had a mean age of 58.5 years while patients with RMS were significantly younger, with a mean age of 44.8 years (P ≤.05). They also had a longer duration of disease (mean, 16.5 years) compared to patients with RMS (mean, 11.3 years). No difference was found in the mean number of DMTs prior to ocrelizumab treatment.

AA patients with RMS (mean, 43.2 years) and PPMS (mean, 55.9 years) were younger than Caucasian patients with RMS (mean, 45.8 years) and PPMS (59.2 years), despite similar disease duration in both groups.

Physician rationales for DMT change were mostly due to suboptimal response (overall, 46.2%; RMS, 41.5%; PPMS, 56.3%; P ≤.05). Patient rationales for requesting treatment change were mostly due to adverse effects (overall, 22.1%; RMS, 29.6%; PPMS, 6.3%; P ≤.05) and personal choice/convenience (overall, 29.1%; RMS, 26.0%; PPMS, 37%; P ≤.05).

“This retrospective cohort of all patients provides understanding of the types of patients seen at a tertiary referral center and treated with ocrelizumab. PPMS patients tended to be older (as expected) but with longer disease duration before starting DMT; likely because of lack of effective DMTs for this MS subtype previously. AA MS patients were younger at the time of switching to Ocrelizumab, likely secondary to more aggressive disease or potentially differential response to DMT,” Manouvakhova and colleagues concluded.

For more coverage of ACTRIMS Forum 2021, click here.

Manouvakhova O, Jones A, Bashir K. Observations regarding ocrelizumab use at a tertiary referral MS center. Presented at ACTRIMS Annual Forum; February 25-27, 2021. Abstract P076
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