Department of Neurology, University Hospital Center Zagreb, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
Department of Neurology, University Hospital Center Zagreb, Zagreb, Croatia.
Mult Scler Relat Disord. 2021 Feb;48:102704. doi: 10.1016/j.msard.2020.102704. Epub 2020 Dec 21.
To evaluate clinical and laboratory effects of delaying ocrelizumab infusions during the COVID-19 pandemics in people with multiple sclerosis (pwMS).
We have retrospectively searched our electronic database and identified 33 pwMS who had a delay in treatment due to COVID-19 pandemics. The following data were extracted: age, sex, multiple sclerosis (MS) phenotype: relapsing-remitting (RRMS) or primary progressive multiple sclerosis (PPMS), disease duration, Expanded Disability Status scale (EDSS), previous disease modifying therapy (DMT), number of ocrelizumab cycles prior to the lockdown, dates of first ocrelizumab infusion, last ocrelizumab infusion prior to the lockdown and delayed ocrelizumab infusion after the lockdown. Flow cytometry results, relapses and EDSS progression prior to the delayed ocrelizumab infusion after the lockdown were extracted.
The mean time between two ocrelizumab infusion during the lockdown was 7.72±0.64 (range 6.07 to 8.92) months. The mean time between last ocrelizumab infusion and the lymphocyte sampling prior to post COVID infusion was 6.59±0.95 (range 5.18 to 8.49) months. In this period, none of the studied patients had a relapse. In a multivariable linear regression analysis, time from last ocrelizumab infusion to lymphocyte sampling prior to the next infusion was the only significant predictor for CD19 B cells count, when corrected for the number of previous ocrelizumab cycles and MS phenotype (RRMS or PPMS) (B=7.981, 95% C.I. 3.277-12.686, p=0.002).
We have not shown clinical consequences of delaying ocrelizumab due to COVID-19 pandemics. However, the delay in dosing of ocrelizumab was an independent predictor of repopulation of B cells.
评估 COVID-19 大流行期间多发性硬化症（pwMS）患者延迟接受奥瑞珠单抗治疗的临床和实验室效果。
我们回顾性地搜索了电子数据库，确定了 33 名因 COVID-19 大流行而延迟治疗的 pwMS。提取了以下数据：年龄、性别、多发性硬化症（MS）表型：复发缓解型（RRMS）或原发性进展性多发性硬化症（PPMS）、疾病持续时间、扩展残疾状态量表（EDSS）、既往疾病修正治疗（DMT）、封锁前奥瑞珠单抗周期数、首次奥瑞珠单抗输注日期、封锁前最后一次奥瑞珠单抗输注日期以及封锁后延迟的奥瑞珠单抗输注日期。提取封锁后延迟的奥瑞珠单抗输注前的流式细胞术结果、复发和 EDSS 进展情况。
封锁期间两次奥瑞珠单抗输注之间的平均时间为 7.72±0.64（范围 6.07 至 8.92）个月。封锁前最后一次奥瑞珠单抗输注与淋巴细胞采样之间的平均时间为 6.59±0.95（范围 5.18 至 8.49）个月。在此期间，没有研究患者出现复发。在多变量线性回归分析中，校正先前奥瑞珠单抗周期数和 MS 表型（RRMS 或 PPMS）后，从最后一次奥瑞珠单抗输注到下一次输注前淋巴细胞采样的时间是 CD19 B 细胞计数的唯一显著预测因素（B=7.981，95%置信区间 3.277-12.686，p=0.002）。
我们没有显示因 COVID-19 大流行而延迟奥瑞珠单抗治疗的临床后果。然而，奥瑞珠单抗剂量的延迟是 B 细胞再增殖的独立预测因素。
