Maximilian Einsiedler1, Laurent Kremer2,3,4, Marie Fleury2, Nicolas Collongues2,3,4, Jérôme De Sèze2,3,4, Kévin Bigaut2,3,4. 1. Service de Neurologie, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 1 Avenue Molière, 67000, Strasbourg, France. maximilian.einsiedler@chru-strasbourg.fr. 2. Service de Neurologie, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 1 Avenue Molière, 67000, Strasbourg, France. 3. Unité INSERM, 1119 Biopathologie de la Myéline, Neuroprotection et Stratégies Thérapeutiques, Strasbourg, France. 4. Centre d'Investigation Clinique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
Abstract
BACKGROUND: Anti-CD20 monoclonal antibodies are recently introduced treatments in progressive MS and real-world data are lacking. OBJECTIVE: The aim of this study is to describe a cohort of progressive MS patients treated with ocrelizumab or rituximab in a real-world setting. METHODS: This monocentric prospective cohort study at the University Hospital of Strasbourg included patients with primary progressive or secondary progressive MS that started treatment with anti-CD20 antibodies before June 2019. Every six months, patients were assessed using the following standardized clinical evaluations: Expanded Disability Status Scale (EDSS), Timed 25-Foot Walk (T25FW), 9-Hole Peg Test (9-HPT) and Symbol Digit Modalities Test (SDMT). The primary analysis considered EDSS progression (of at least 1.0 if EDSS ≤ 5.5 and at least 0.5 if EDSS ≥ 6.0). RESULTS: We included 108 patients, with a median age upon inclusion of 53 years [48.0-58.0]. 72% were classified as primary progressive forms. Median baseline EDSS was 6.0 [4.0-6.5]. EDSS was significantly correlated with T25FW, SDMT and 9-HPT. Following 2 years of treatment, 38.9% of patients presented EDSS progression compared to baseline. CONCLUSION: Our large cohort confirms tolerance of these treatments in a real-world setting. Standardized clinical assessments could improve detection of deteriorating patients. Further studies are needed to establish predictive factors.
BACKGROUND: Anti-CD20 monoclonal antibodies are recently introduced treatments in progressive MS and real-world data are lacking. OBJECTIVE: The aim of this study is to describe a cohort of progressive MS patients treated with ocrelizumab or rituximab in a real-world setting. METHODS: This monocentric prospective cohort study at the University Hospital of Strasbourg included patients with primary progressive or secondary progressive MS that started treatment with anti-CD20 antibodies before June 2019. Every six months, patients were assessed using the following standardized clinical evaluations: Expanded Disability Status Scale (EDSS), Timed 25-Foot Walk (T25FW), 9-Hole Peg Test (9-HPT) and Symbol Digit Modalities Test (SDMT). The primary analysis considered EDSS progression (of at least 1.0 if EDSS ≤ 5.5 and at least 0.5 if EDSS ≥ 6.0). RESULTS: We included 108 patients, with a median age upon inclusion of 53 years [48.0-58.0]. 72% were classified as primary progressive forms. Median baseline EDSS was 6.0 [4.0-6.5]. EDSS was significantly correlated with T25FW, SDMT and 9-HPT. Following 2 years of treatment, 38.9% of patients presented EDSS progression compared to baseline. CONCLUSION: Our large cohort confirms tolerance of these treatments in a real-world setting. Standardized clinical assessments could improve detection of deteriorating patients. Further studies are needed to establish predictive factors.
Authors: K Daniels; P B van der Nat; S T F M Frequin; P J van der Wees; D H Biesma; E L J Hoogervorst; E M W van de Garde Journal: Mult Scler Int Date: 2020-06-15