Fatigue and Other Patient-Reported Outcomes in Patients With RRMS who Switched to Ocrelizumab: 4-Year Data From CASTING-LIBERTO
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

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).


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.


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.


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).

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.