Block Valerie J, Henderson Kyra, Poole Shane, Joseph Gabby B, Gelfand Jeffrey M, Cree Bruce Ac, Bove Riley
Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA; Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, USA.
Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.
Mult Scler J Exp Transl Clin. 2025 Mar 25;11(1):20552173251329817. doi: 10.1177/20552173251329817. eCollection 2025 Jan-Mar.
Patients with multiple sclerosis (MS) on some disease-modifying therapies (i.e., natalizumab), report a "wearing-off" effect characterized by increased symptoms directly before infusions. Prior research suggests this may reflect natural MS fluctuations rather than true treatment waning; however, this has not been confirmed for anti-CD20 agents (e.g., ocrelizumab). Daily step count (STEPS) can reflect overall function. This study examined temporal associations between anti-CD20 therapy infusions and STEPS.
Retrospective analysis evaluated data from two Fitbit-monitored cohorts ( = 145 total, 32 anti-CD20-treated participants) across 60 treatment cycles. Monthly STEPS were recorded directly pre- and three-month post-infusion over the six-month treatment intervals. Mixed-effects models evaluated the relationship between infusion timing, STEPS, and participant demographics, controlling for confounding variables.
No significant difference in STEPS was observed pre- versus post-infusion ( = 0.32). An average decrease of 3.3% was noted post-infusion but was not statistically significant. No associations between STEPS and participant characteristics (e.g., age, disability level) were identified. Individual variability existed, but no clear group-level trends emerged.
This study found no evidence of an association between timing of anti-CD20 infusion and changes in STEPS. Findings highlight the need for integrating objective measures with patient-reported outcomes and biomarkers in future research to better understand potential treatment fluctuations.
接受某些疾病修正疗法（即那他珠单抗）治疗的多发性硬化症（MS）患者报告有一种“药效消退”效应，其特征是在输液前症状加重。先前的研究表明，这可能反映的是MS的自然波动，而非真正的治疗效果减弱；然而，抗CD20药物（如奥瑞珠单抗）的这一情况尚未得到证实。每日步数（STEPS）可以反映整体功能。本研究调查了抗CD20治疗输液与STEPS之间的时间关联。
回顾性分析评估了来自两个由Fitbit监测的队列（共145人，32名接受抗CD20治疗的参与者）在60个治疗周期的数据。在六个月的治疗间隔内，每月在输液前及输液后三个月直接记录STEPS。混合效应模型评估了输液时间、STEPS与参与者人口统计学特征之间的关系，并对混杂变量进行了控制。
输液前和输液后STEPS无显著差异（P = 0.32）。输液后平均下降了3.3%，但无统计学意义。未发现STEPS与参与者特征（如年龄、残疾程度）之间存在关联。存在个体差异，但未出现明显的组水平趋势。
本研究未发现抗CD20输液时间与STEPS变化之间存在关联的证据。研究结果强调，在未来的研究中需要将客观测量与患者报告的结果和生物标志物相结合，以更好地理解潜在的治疗波动。
