African-American MS Patients with and Without Early B-cell Repletion After Anti-CD20 Monoclonal Infusion Therapy Have Similarly Low Levels of Disease Activity
Hannah Kopinsky1, Angie Kim1, Abhimanyu Amarnani2, Arnaldo Arbini3, David Fenyo4, Gregg J. Silverman2, Ilya Kister1
1Neurology, 2Internal Medicine, 3Pathology, 4Biochemistry and Molecular Pharmacology, NYU Grossman School of Medicine
Objective:
To compare disease activity in MS patients of African descent on anti-CD20 therapy with early B-cell repletion (‘early repletion’, ER) to patients without early B-cell repletion (‘normal repletion’, NR).
Background:
Infusable anti-CD20 therapies cause complete peripheral B-cell depletion for 6 months following treatment in >95% of patients in clinical trials, though African ancestry is associated with earlier B-cell repletion. It is not known whether relapses and/or new MRI lesions are more common in patients with early B-cell repletion.
Design/Methods:
We retrospectively reviewed charts of African-American patients with MS attending the NYU Multiple Sclerosis Care Center on anti-CD20 therapy. We identified ER and NR patients with similar demographic characteristics and extracted data on neurologist-confirmed relapses and MRI activity for the duration of anti-CD20 therapy. Exclusion criteria were BMI>40 and >12 month breaks in therapy. Annual relapse rates and new MRI lesion formation were compared between the groups using a z-test for proportions.
Results:
We identified 18 patients with ER (female=14, age: mean=37.9 years [SD=12.9], mean duration on anti-CD20 therapy=5 years) and 23 patients with NR (female=20, age: mean=42.3 years [SD=9.9], mean duration on anti-CD20 therapy=4.9 years). Relapses were recorded in 4 ER patients (22%; mean annual relapse rate of 4%) and 5 NR patients (22%; mean annual relapse rate of 4%) (p=0.998). 88 MRI were reviewed in ER group and 91 MRI in NR group. New MRI lesions were observed in 4 ER patients (22%; mean annual lesion formation rate of 4%) and in 3 NR patients (13%; mean annual lesion formation rate of 2.7%) (p=0.816).
Conclusions:
In anti-CD20 treated African-American patients with MS, disease activity was similarly low with or without early B-cell repletion. Our findings are consistent with the growing evidence that re-emergence of B-cells with an extended anti-CD20 dosing period is not associated with disease recurrence.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.