Signoriello E, Bonavita S, Di Pietro A, Abbadessa G, Rossi F, Miele G, Casertano S, Lus G
Multiple Sclerosis Centre, II Division of Neurology, Department of Clinical and Experimental Medicine, University of Campania Luigi Vanvitelli, Italy.
Multiple Sclerosis Centre, II Division of Neurology, Department of Clinical and Experimental Medicine, University of Campania Luigi Vanvitelli, Italy.
Mult Scler Relat Disord. 2020 Aug;43:102186. doi: 10.1016/j.msard.2020.102186. Epub 2020 May 17.
Ocrelizumab (OCR) is a humanized monoclonal antibody targeting CD20 antigen exposed on B cells surface. Kinetic of B-cells repopulation after depletion therapy shows high intra and inter-individual variability. The aim of this study was to explore the influence of Body Mass Index (BMI) on kinetic of B-cell repopulation after treatment with OCR and on treatment response.
108 Multiple Sclerosis (MS) patients were enrolled at the time of the first dose of OCR administration and prospectively evaluated. Clinical, instrumental activity and disability progression were analyzed. According to B cells count, patients were divided into two groups: with fast (FR) and with slow (SR) repopulation rate, respectively.
Significant reduction of disease activity was observed in all patients and a stabilization of disease was obtained in progressive patients. Patients with FR had higher BMI compared to patients with a SR (p<0.001). Contrariwise no correlation between repopulation rate and treatment effectiveness was disclosed.
In a real world setting we confirmed the effectiveness of OCR in relapsing remitting and progressive patients; patients with higher BMI had a FR. This suggests considering BMI for administration schedule although further investigations with longer follow up could improve treatment protocol and patient selection.
奥瑞珠单抗（OCR）是一种靶向B细胞表面暴露的CD20抗原的人源化单克隆抗体。耗竭疗法后B细胞再增殖的动力学显示出个体内和个体间的高度变异性。本研究的目的是探讨体重指数（BMI）对OCR治疗后B细胞再增殖动力学及治疗反应的影响。
108例多发性硬化症（MS）患者在首次给予OCR时入组并进行前瞻性评估。分析临床、影像学活动及残疾进展情况。根据B细胞计数，患者分别分为两组：再增殖率快（FR）组和再增殖率慢（SR）组。
所有患者的疾病活动度均显著降低，进展型患者的病情得到稳定。FR组患者的BMI高于SR组患者（p<0.001）。相反，未发现再增殖率与治疗效果之间存在相关性。
在实际临床环境中，我们证实了OCR对复发缓解型和进展型患者的有效性；BMI较高的患者再增殖率快。这表明在制定给药方案时应考虑BMI，尽管进一步的长期随访研究可能会改进治疗方案和患者选择。
