J Rigal1, G Pugnet2, J Ciron3, Z Lépine1, D Biotti4. 1. Pole des Neurosciences, B4 Neurology Unit, CHU Purpan, Toulouse, France. 2. Département de Médecine Interne, CHU Purpan, Toulouse, France. 3. Pole des Neurosciences, B4 Neurology Unit, CHU Purpan, Toulouse, France; Centre de Ressources et de Compétences Sclérose en plaques (CRC-SEP, CHU Purpan, Toulouse, France). 4. Pole des Neurosciences, B4 Neurology Unit, CHU Purpan, Toulouse, France; Centre de Ressources et de Compétences Sclérose en plaques (CRC-SEP, CHU Purpan, Toulouse, France). Electronic address: biotti.d@chu-toulouse.fr.
Abstract
BACKGROUND: The objective of the study was to evaluate the indication, efficacy and safety of tocilizumab, a humanized anti-interleukin-6 receptor antibody, in patients with neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein antibody associated diseases (MOGAD) encountered in current neurological practice. MATERIAL AND METHODS: We conducted a retrospective analysis of an exhaustive cohort of patients with inflammatory CNS disorders at Toulouse University Hospital, France, from 2014 to 2020. Efficacy was evaluated with clinical outcome by the Annual Relapse Rate, and radiological outcome with MRI data. The other outcomes were adverse events and effectiveness according to the form of injection (intravenous or subcutaneous). RESULTS: Seven patients were treated with tocilizumab: four patients had NMOSD with AQP4+ antibodies (57%) and three had MOGAD (43%). Tocilizumab was administered in the presence of persistent clinical activity and/or severe side effects with other immunosuppressant medications. The median follow-up on tocilizumab was 23 months (4-50 months). All patients started with monthly intravenous injection, then three switched to a subcutaneous form. All patients were relapse-free throughout the duration of treatment with tocilizumab, and one presented with a new cervical lesion on MRI. Four patients had no adverse effect, two had a significant increase in infection rate, and one had dyslipidemia. CONCLUSION: tocilizumab appears to be an effective therapy for patients with refractory NMOSD or MOGAD. Subcutaneous and intravenous injections appear to be equally effective.
BACKGROUND: The objective of the study was to evaluate the indication, efficacy and safety of tocilizumab, a humanized anti-interleukin-6 receptor antibody, in patients with neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein antibody associated diseases (MOGAD) encountered in current neurological practice. MATERIAL AND METHODS: We conducted a retrospective analysis of an exhaustive cohort of patients with inflammatory CNS disorders at Toulouse University Hospital, France, from 2014 to 2020. Efficacy was evaluated with clinical outcome by the Annual Relapse Rate, and radiological outcome with MRI data. The other outcomes were adverse events and effectiveness according to the form of injection (intravenous or subcutaneous). RESULTS: Seven patients were treated with tocilizumab: four patients had NMOSD with AQP4+ antibodies (57%) and three had MOGAD (43%). Tocilizumab was administered in the presence of persistent clinical activity and/or severe side effects with other immunosuppressant medications. The median follow-up on tocilizumab was 23 months (4-50 months). All patients started with monthly intravenous injection, then three switched to a subcutaneous form. All patients were relapse-free throughout the duration of treatment with tocilizumab, and one presented with a new cervical lesion on MRI. Four patients had no adverse effect, two had a significant increase in infection rate, and one had dyslipidemia. CONCLUSION:tocilizumab appears to be an effective therapy for patients with refractory NMOSD or MOGAD. Subcutaneous and intravenous injections appear to be equally effective.
Authors: Marius Ringelstein; Ilya Ayzenberg; Gero Lindenblatt; Katinka Fischer; Anna Gahlen; Giovanni Novi; Helen Hayward-Könnecke; Sven Schippling; Paulus S Rommer; Barbara Kornek; Tobias Zrzavy; Damien Biotti; Jonathan Ciron; Bertrand Audoin; Achim Berthele; Katrin Giglhuber; Helene Zephir; Tania Kümpfel; Robert Berger; Joachim Röther; Vivien Häußler; Jan-Patrick Stellmann; Daniel Whittam; Anu Jacob; Markus Kraemer; Antoine Gueguen; Romain Deschamps; Antonios Bayas; Martin W Hümmert; Corinna Trebst; Axel Haarmann; Sven Jarius; Brigitte Wildemann; Matthias Grothe; Nadja Siebert; Klemens Ruprecht; Friedemann Paul; Nicolas Collongues; Romain Marignier; Michael Levy; Michael Karenfort; Michael Deppe; Philipp Albrecht; Kerstin Hellwig; Ralf Gold; Hans-Peter Hartung; Sven G Meuth; Ingo Kleiter; Orhan Aktas Journal: Neurol Neuroimmunol Neuroinflamm Date: 2021-11-16