De-escalation of Disease-Modifying Therapy for People with Multiple Sclerosis Due to Safety Considerations: Characterizing 1-Year Outcomes in 25 People Who Switched from Ocrelizumab to Diroximel Fumarate

• DOI: 10.1007/s12325-024-02902-0
• Publication Date: 2024-06-11T09:05:35Z
• Authors: Mark Gudesblatt; Barbara Bumstead; Marijean Buhse; Myassar Zarif; Sarah A. Morrow; Jacqueline A. Nic...; Laura M. Hancock; Jeffrey Wilken; Joanna Weller; Nicole Scott; Anne Gocke; James B. Lewin; Olivia Kaczmarek; Jason P. Mendoza; Daniel Golan
• Keywords: Ocrelizumab

Switching disease-modifying therapy (DMT) may be considered for relapsing–remitting multiple sclerosis (RRMS) if a patient's current is no longer optimal. This was particularly important during the recent COVID-19 pandemic because of considerations around immune deficiency and impaired vaccine response associated with B cell-depleting DMTs. real-world, single-center study aimed to evaluate change or decline in functional ability overall disease stability people RRMS who were switched from ocrelizumab (OCRE) diroximel fumarate (DRF) safety concern related pandemic. Adults included they had been clinically stable ≥ 1 year on OCRE. Data collected at baseline post switch relapse rate, magnetic resonance imaging (MRI), blood work assessment peripheral parameters, Cognitive Assessment Battery (CAB), optical coherence tomography (OCT), patient-reported outcomes (PROs). Participants (N = 25) mean (SD) age 52 (9) years, duration 26 (8) months' treatment OCRE before DRF. Median washout since last infusion 7 months (range 4–18 months). No participants relapsed DRF follow-up, all remained persistent after year. There significant changes other than an increase percentage CD19+ cells switching (p < 0.05). Similarly, there CAB, OCT, PROs. These preliminary findings suggest that transition effective option are but need reasons unrelated effectiveness. Longer follow-up times larger samples needed confirm these observations.