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

Gianmarco Abbadessa, Giuseppina Miele, Paola Cavalla, Paola Valentino, Girolama Alessandra Marfia, Elisabetta Signoriello, Doriana Landi, Chiara Bosa, Marco Vercellino, Antonio De Martino, Rosanna Missione, Maddalena Sparaco, Luigi Lavorgna, Giacomo Lus and Simona Bonavita
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Gianmarco Abbadessa: Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Giuseppina Miele: Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Paola Cavalla: Multiple Sclerosis Center, AOU Città della Salute e della Scienza di Torino, 10147 Turin, Italy
Paola Valentino: Institute of Neurology, University “Magna Graecia”, 88100 Catanzaro, Italy
Girolama Alessandra Marfia: Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
Elisabetta Signoriello: Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Doriana Landi: Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
Chiara Bosa: Multiple Sclerosis Center, AOU Città della Salute e della Scienza di Torino, 10147 Turin, Italy
Marco Vercellino: Multiple Sclerosis Center, AOU Città della Salute e della Scienza di Torino, 10147 Turin, Italy
Antonio De Martino: Institute of Neurology, University “Magna Graecia”, 88100 Catanzaro, Italy
Rosanna Missione: Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Maddalena Sparaco: Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Luigi Lavorgna: Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Giacomo Lus: Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Simona Bonavita: Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy

IJERPH, 2021, vol. 18, issue 15, 1-11

Abstract: 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.

Keywords: multiple sclerosis; ocrelizumab; schedule; B cell; CD20; CD19; kinetics (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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