- Title
- Prediction of multiple sclerosis outcomes when switching to ocrelizumab
- Creator
- Zhong, Michael; van der Walt, Anneke; Macdonell, Richard; Prevost, Julie; Kuhle, Jens; Laureys, Guy; Van Hijfte, Liesbeth; Alroughani, Raed; Kermode, Allan G.; Butler, Ernest; Barnett, Michael; Eichau, Sara; Stankovich, Jim; van Pesch, V; Grammond, P; McCombe, P; Karabudak, R; Duquette, P; Girard, M; Taylor, B; Yeh, W; Monif, M; Gresle, M; Kalincik, Tomas; Butzkueven, H; Jokubaitis, VG; Buzzard, Katherine; Skibina, Olga; Boz, Cavit; Hodgkinson, Suzanne; Slee, Mark; Lechner-Scott, Jeanette
- Relation
- Multiple Sclerosis Journal Vol. 28, Issue 6, p. 958-969
- Publisher Link
- http://dx.doi.org/10.1177/13524585211049986
- Publisher
- Sage Publications
- Resource Type
- journal article
- Date
- 2022
- Description
- Background: Increasingly, people with relapsing-remitting multiple sclerosis (RRMS) are switched to highly effective disease-modifying therapies (DMTs) such as ocrelizumab. Objective: To determine predictors of relapse and disability progression when switching from another DMT to ocrelizumab. Methods: Patients with RRMS who switched to ocrelizumab were identified from the MSBase Registry and grouped by prior disease-modifying therapy (pDMT; interferon-β/glatiramer acetate, dimethyl fumarate, teriflunomide, fingolimod or natalizumab) and washout duration (<1 month, 1–2 months or 2–6 months). Survival analyses including multivariable Cox proportional hazard regression models were used to identify predictors of on-ocrelizumab relapse within 1 year, and 6-month confirmed disability progression (CDP). Results: After adjustment, relapse hazard when switching from fingolimod was greater than other pDMTs, but only in the first 3 months of ocrelizumab therapy (hazard ratio (HR) = 3.98, 95% confidence interval (CI) = 1.57–11.11, p = 0.004). The adjusted hazard for CDP was significantly higher with longer washout (2–6 m compared to <1 m: HR = 9.57, 95% CI = 1.92–47.64, p = 0.006). Conclusion: The risk of disability worsening during switch to ocrelizumab is reduced by short treatment gaps. Patients who cease fingolimod are at heightened relapse risk in the first 3 months on ocrelizumab. Prospective evaluation of strategies such as washout reduction may help optimise this switch.
- Subject
- ocrelizumab; fingolimod; switch; washout
- Identifier
- http://hdl.handle.net/1959.13/1462625
- Identifier
- uon:46515
- Identifier
- ISSN:1352-4585
- Language
- eng
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