Occurrence of Late-Onset Neurotropenia After Anti-CD20 Therapy: Tianrong Yeo, PhD, MBBS, MRCP, MMED, FAMS, MCI

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“For both of our patients in the report, we actually reinitiated the anti-CD 20 therapy, and they did well in a sense that it didn't reoccur, and they still continue to use the drugs.”

Anti-CD20 therapies have become increasingly used to treat neuroinflammatory conditions such as multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD). It has been described that late-onset neurotropenia (LON), a rare adverse event, can be found following use of treatments such as rituximab (Rituxan; Genentech/Biogen) and ocrelizumab (Ocrevus; Genentech).

A recently conducted report on two patients treated with an anti-CD20 therapy who developed LON was published in Neuroimmunology Reports.¹ After the report on the two patients, a retrospective chart review was conducted on patients with neuroinflammatory conditions on anti-CD20 therapies from January 2015 to December 2021. The review identified 77 patients as having multiple sclerosis (MS; n = 41) or NMOSD(n = 26). In addition, 9 patients with MS were given ocrelizumab and the rest of the patients received rituximab (MS and NMOSD, n = 58).

The data was collected over a 7-year period and the incidence rate was 11% for the two patients reported with LON.¹ In addition, the rate for using the treatments of ocrelizumab and rituximab for patients with LON was 1.7%, respectively. There was a 3.0% rate for the overall use of anti-CD20 treatment with the patients in the report.

Recently in an interview with NeurologyLive^®, coauthor Tianrong Yeo, PhD, MBBS, MRCP, MMED, FAMS, MCI, discussed what the study means for patients with neuroinflammatory conditions and the level of awareness that clinicians should have about LON. Yeo, a senior consultant in the department of neurology at the National Neuroscience Institute, also spoke on clinicians changing their treatment strategies for patients who develop this adverse event, along with the specific research needed to be conducted.

REFERENCES
1. Lim CS, Tye JS, Tan K, Yeo T. Late-onset neutropenia following anti-CD20 therapies in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders: A report on two patients. Neuroimmunol Rep. 2022; 100136. doi:10.1016/j.nerep.2022.100136