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奥瑞珠单抗在多发性硬化症中的延长间隔给药。

Extended interval dosing with ocrelizumab in multiple sclerosis.

机构信息

Department of Neurology, Esbjerg Hospital, University Hospital of Southern Denmark, Esbjerg, Denmark.

Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.

出版信息

Mult Scler. 2024 Jun;30(7):847-856. doi: 10.1177/13524585241245296. Epub 2024 Apr 22.

Abstract

BACKGROUND

This study investigates clinical and biomarker differences between standard interval dosing (SID) and extended interval dosing (EID) of ocrelizumab therapy in multiple sclerosis (MS).

METHODS

This is a prospective, double-arm, open-label, multi-center study in Denmark. Participants diagnosed with MS on ocrelizumab therapy >12 months were included ( = 184). Clinical, radiological, and blood-based biomarker outcomes were evaluated. MRI disease activity, relapses, worsening of neurostatus, and No Evidence of Disease Activity-3 (NEDA-3) were used as a combined endpoint.

RESULTS

Out of 184 participants, 107 participants received EID (58.2%), whereas 77 participants received SID (41.8%). The average extension was 9 weeks with a maximum of 78 weeks. When comparing EID to SID, we found higher levels of B-cells, lower serum concentrations of ocrelizumab, and similar levels of age-adjusted NFL and GFAP in the two groups. No difference in NEDA-3 between EID and SID was demonstrated (hazard ratio: 1.174, = 0.69). Higher levels of NFL were identified in participants with disease activity. Body mass index correlated with levels of ocrelizumab and B-cells.

CONCLUSION

Extending one treatment interval of ocrelizumab on average 9 weeks and up to 78 weeks did not result in clinical, radiological, or biomarker evidence of worsening compared with SID.

摘要

背景

本研究旨在探究奥瑞珠单抗治疗多发性硬化症(MS)时标准间隔给药(SID)与延长间隔给药(EID)的临床和生物标志物差异。

方法

这是一项在丹麦进行的前瞻性、双臂、开放标签、多中心研究。纳入接受奥瑞珠单抗治疗>12 个月且被诊断为 MS 的患者(n=184)。评估了临床、影像学和基于血液的生物标志物结果。MRI 疾病活动度、复发、神经状态恶化和无疾病活动-3(NEDA-3)被用作综合终点。

结果

在 184 名参与者中,107 名参与者接受了 EID(58.2%),77 名参与者接受了 SID(41.8%)。平均延长时间为 9 周,最长为 78 周。与 SID 相比,EID 组的 B 细胞水平更高,血清奥瑞珠单抗浓度更低,年龄调整后 NFL 和 GFAP 水平相似。EID 和 SID 之间的 NEDA-3 无差异(风险比:1.174,P=0.69)。疾病活动参与者的 NFL 水平更高。体重指数与奥瑞珠单抗和 B 细胞水平相关。

结论

与 SID 相比,平均延长奥瑞珠单抗治疗间隔 9 周,最长可达 78 周,并未导致临床、影像学或生物标志物恶化的证据。

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