The objective of this study was to evaluate the clinical consequences of extended interval dosing (EID) of ocrelizumab in relapsing-remitting multiple sclerosis (RRMS) during the coronavirus disease 2019 (COVID-19) pandemic. In this retrospective, multicenter cohort study, the authors compared patients with RRMS on EID (defined as ≥4-week delay of dose interval) with a control group on standard interval dosing (SID) at the same period (January to December 2020). Three hundred eighteen patients with RRMS were longitudinally evaluated in 5 German centers. One hundred sixteen patients received ocrelizumab on EID (median delay [interquartile range 8.68 [5.09–13.07] weeks). Three months after the last ocrelizumab infusion, 182 (90.1%) patients following SID and 105 (90.5%) EID patients remained relapse free (p = 0.903). Three-month confirmed progression of disability was observed in 18 SID patients (8.9%) and 11 EID patients (9.5%, p = 0.433). MRI progression was documented in 9 SID patients (4.5%) and 8 EID patients (6.9%) at 3-month follow-up (p = 0.232). Multivariate logistic regression showed no association between treatment regimen and no evidence of disease activity status at follow-up (OR: 1.266 [95% CI: 0.695–2.305]; p = 0.441). Clinical stability was accompanied by persistent peripheral CD19+ B-cell depletion in both groups (SID vs EID: 82.6% vs 83.3%, p = 0.463). The authors concluded that disease activity in their cohort was not associated with CD19+ B-cell repopulation underlying that their data support EID of ocrelizumab as potential risk mitigation strategy in times of the COVID-19 pandemic.
Leoni Rolfes, Marc Pawlitzki, Steffen Pfeuffer, Christopher Nelke, Anke Lux, Refik Pul, Christoph Kleinschnitz, Konstanze Kleinschnitz, Rebeca Rogall, Katrin Pape, Stefan Bittner, Frauke Zipp, Clemens Warnke, Yasemin Goereci, Michael Schroeter, Jens Ingwersen, Orhan Aktas, Luisa Klotz, Tobias Ruck, Heinz Wiendl, Sven G. Meuth. Ocrelizumab Extended Interval Dosing in Multiple Sclerosis in Times of COVID-19. Neurol Neuroimmunol Neuroinflamm Sep 2021, 8 (5) e1035; DOI: 10.1212/NXI.0000000000001035.