CD19 Cell Count at Baseline Predicts B Cell Repopulation at 6 and 12 Months in Multiple Sclerosis Patients Treated with Ocrelizumab

International Journal of Environmental Research and Public Health

Elisabetta Signoriello¹  Simona Bonavita¹  Rosanna Missione¹  Maddalena Sparaco¹  Giuseppina Miele¹  Luigi Lavorgna¹  Giacomo Lus¹  Gianmarco Abbadessa¹  Paola Valentino²  Antonio De Martino²  Paola Cavalla³  Chiara Bosa³  Marco Vercellino³  Doriana Landi⁴  Girolama Alessandra Marfia⁴ 

[1] Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;Institute of Neurology, University “Magna Graecia”, 88100 Catanzaro, Italy;Multiple Sclerosis Center, AOU Città della Salute e della Scienza di Torino, 10147 Turin, Italy;Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy;

关键词: multiple sclerosis;    ocrelizumab;    schedule;    B cell;    CD20;    CD19;   

DOI  :  10.3390/ijerph18158163

来源: DOAJ

【 摘 要 】

Background: The kinetics of B cell repopulation in MS patients treated with Ocrelizumab is highly variable, suggesting that a fixed dosage and time scheduling might be not optimal. We aimed to investigate whether B cell repopulation kinetics influences clinical and radiological outcomes and whether circulating immune asset at baseline affects B cell repopulation kinetics. Methods: 218 MS patients treated with Ocrelizumab were included. Every six months we collected data on clinical and magnetic resonance imaging (MRI) activity and lymphocyte subsets at baseline. According to B cell counts at six and twelve months, we identified two groups of patients, those with fast repopulation rate (FR) and those with slow repopulation rate (SR). Results: A significant reduction in clinical and radiological activity was found. One hundred fifty-five patients had complete data and received at least three treatment cycles (twelve-month follow-up). After six months, the FR patients were 41/155 (26.45%) and 10/41 (29.27%) remained non-depleted after twelve months. FR patients showed a significantly higher percentage of active MRI scan at twelve months (17.39% vs. 2.53%; p = 0,008). Furthermore, FR patients had a higher baseline B cell count compared to patients with an SR (p = 0.02 and p = 0.002, at the six- and twelve-month follow-ups, respectively). Conclusion: A considerable proportion of MS patients did not achieve a complete CD19 cell depletion and these patients had a higher baseline CD19 cell count. These findings, together with the higher MRI activity found in FR patients, suggest that the Ocrelizumab dosage could be tailored depending on CD19 cell counts at baseline in order to achieve complete disease control in all patients.

【 授权许可】

Unknown