Ocrelizumab in the treatment of multiple sclerosis: real-world clinical practice experience in the Yaroslavl region

   The most significant results in terms of efficacy in relapsing-remitting multiple sclerosis (MS) and primary progressive MS have been demonstrated for the drug ocrelizumab. Despite the significant role of randomised clinical trials in the study of the drug, the accumulation of experience in the real-world clinical practice of using ocrelizumab broadens the understanding of the drug's importance in the treatment of MS.

   Objective: to investigate the use of ocrelizumab in patients with MS living in the Yaroslavl region, as well as immunological predictors of ocrelizumab efficacy.

   Material and methods. The study included data from 107 patients diagnosed with MS according to the 2017 McDonald criteria (33 men and 74 women; median age – 42.1 [34.5; 49.7] years), with a disease duration of 10.3 [6.7; 16.9] years, and duration of therapy prior to starting ocrelizumab of 36.6 [25.9; 47.8] months. The efficacy and safety of therapy were analysed over 24 months of treatment.

   Results. A significant reduction in the frequency of exacerbations over 24 months of therapy was observed in the overall cohort of patients, from 0.53 to 0.10 per year (Z = 4.06; p < 0.001), and in MRI activity – from 1.38 to 0.09 new lesions on T2 images per year (Z = 3.88; p < 0.001). The overall NEDA-3 rate over 24 months of therapy was 76.64 %. It has been shown that a CD19⁺ level above 20 cells/ml before the second infusion of the drug may indicate the onset of disease activity in the following 18 months.

   Conclusion. The data obtained confirm the three-year efficacy and safety of ocrelizumab. The treatment has been shown to have a positive effect on NEDA-3 status.

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