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#Post#: 4972--------------------------------------------------
(ECTRIMS) Ocrelizumab may double serious infection risk in MS
By: agate Date: October 26, 2025, 8:06 pm
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From MedPage Today (September 28, 2025)--"Ocrelizumab may double
serious infection risk in MS":
https://www.medpagetoday.com/meetingcoverage/ectrims/117680
The abstract:
[font=arial]Long-term safety risks among patients with multiple
sclerosis treated with ocrelizumab: An observational
study[/font]
[font=arial]
Alise K. Carlson1, Mengke Du1, Scott Husak1, Jeffrey Cohen1,
Robert J. Fox1, Daniel Ontaneda1[/font]
[font=arial]
1Mellen Center for Multiple Sclerosis Treatment and Research,
Neurological Institute, Cleveland Clinic, Cleveland, OH, United
States[/font]
Introduction:
The use of B-cell depleting therapies for treatment of multiple
sclerosis (MS) has been associated with good control of disease
activity and prevention of long-term disability accrual but may
also be associated with increased risk of serious infections.
Objectives/Aims:
To characterize the magnitude of this risk in a large real-world
population.
Methods:
Retrospective data from the Mellen Center for Multiple Sclerosis
Treatment and Research at the Cleveland Clinic were used to
analyze the incidence of serious infections in MS patients
treated with ocrelizumab compared to a propensity-matched cohort
of patients treated with platform injectable therapies, to
evaluate differences in time from treatment onset to first
serious infection, and to examine the relationship between
immunoglobulin levels and incidence of serious infections in
patients treated with ocrelizumab. Incidence of serious
infections between those treated with ocrelizumab aged <55,
55-60, and >60 years was also assessed.
Results:
The risk for serious infection was higher in patients treated
with ocrelizumab (n = 2,551) than for patients treated with
platform injectable therapies (n = 1,307) in a
propensity-matched cohort (OR 1.98 [1.52, 2.59], p = <0.001).
The rate of serious infections per 100 person-years for the
ocrelizumab and platform injectable therapies groups were 4.21
and 2.64, respectively. Time to first serious infection was
shorter in the ocrelizumab-treated cohort (HR 1.86 [95% CI 1.45,
2.39]). Hypogammaglobulinemia was not associated with increased
risk of serious infection(s) in ocrelizumab-treated patients
(1.36 [95% CI 0.99, 1.89], p = 0.07 for IgG and 1.21 [95% CI
0.90, 1.63], p = 0.21 for IgM, respectively). Within the
ocrelizumab cohort, analysis based on age demonstrated no
significant differences in risk for serious infection (55-60, OR
1.11 [95% CI, 0.74-1.65]; >60, OR 1.38 [95% CI, 0.91-2.09]).
Conclusion:
These findings pertaining to risk of serious infection are
consistent with those reported in the clinical trials and
extension studies, and other observational real-world cohorts.
The results provide the magnitude of this risk in comparison to
platform treatment and may facilitate shared decision making
between patients and providers to select disease modifying
therapy.
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