2023 American Academy of Neurology Abstract Website

Ilya Kister¹, Ralph Benedict², Giancarlo Comi³, Gary Cutter⁴, Celia Oreja Guevara⁵, Susanne Clinch⁶, Thomas Kuenzel⁷, Petra Dirks⁷, Patrick Vermersch⁸
¹New York University Langone Medical Center, Multiple Sclerosis Comprehensive Care Center, New York, NY, USA, ²Jacobs School of Medicine and Biomedical Sciences, Department of Neurology, University of Buffalo, NY, USA, ³Vita-Salute San Raffaele University and Casa di Cura del Policlinico, Milan, Italy, ⁴Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA, ⁵Hospital Clinico San Carlos, Madrid, Spain, ⁶Roche Products Ltd, ⁷F. Hoffmann-La Roche Ltd, Basel, Switzerland, ⁸Univ. Lille, Inserm U1172 LilNCog, CHU Lille, FHU Precise, Lille, France

Objective:

To report changes over 4 years in patient-reported outcomes (PROs) in people with relapsing-remitting multiple sclerosis (PwRRMS) who were switched to ocrelizumab after suboptimal response to disease-modifying therapies (DMTs).

Background:

PwRRMS may experience increased symptom severity (particularly fatigue), impaired working capacity and compromised quality-of-life (QoL) despite treatment with DMTs. The CASTING study (NCT02861014) examined changes in PROs over time in PwRRMS who were switched to ocrelizumab after suboptimal response to ≥6 months of other DMT treatment; eligible patients were enrolled into the LIBERTO (NCT03599245) open-label extension study.

Design/Methods:

PwRRMS completing the 2-year CASTING study were offered enrolment in LIBERTO and continued ocrelizumab 600mg every 24 weeks for a further 2 years. Severity of symptoms, employment status and health-related QoL were assessed using SymptoMScreen, Work Productivity and Activity Impairment (WPAI) questionnaire and Multiple Sclerosis Impact Scale-29 (MSIS-29). Spearman correlation coefficients (SCC) determined changes between SymptoMScreen total score, fatigue item and WPAI domain scores, as well as MSIS-29 (physical/psychological sub-scores), from baseline to Year 4.

Results:

At Year 4, relative to baseline, statistically significant improvements were observed in overall SymptoMScreen score (14.4% [12.4]–11.9% [11.5], [SD] p<0.001) and SymptoMScreen fatigue item score (2.1% [1.6]–1.7% [1.6], p<0.001). Trends toward improvements were observed in other SymptoMScreen items, MSIS-29 scores (physical, 21.16% [20.60]–17.47% [20.12]; psychological, 32.03% [23.68]–23.03% [21.68]) and WPAI scores (work productivity, 22.94% [26.74]–16.52% [21.41]; activity impairment, 29.71% [27.72]–22.93% [26.51]). Changes in SymptoMScreen fatigue item (highest at baseline relative to other domains) correlated with changes in WPAI work productivity sub-score (SCC: 0.327) and MSIS-29 (physical/psychological sub-scores; SCC: 0.563/0.502).

Conclusions:

PwRRMS who switched to ocrelizumab after a suboptimal response to prior DMTs reported improvement in their overall symptom limitations (total SymptoMScreen) and fatigue over 4 years, which may contribute to improved work productivity and QoL.