@article {Smoote000108, author = {Kyle Smoot and Chiayi Chen and Tamela Stuchiner and Lindsay Lucas and Lois Grote and Stanley Cohan}, title = {Clinical outcomes of patients with multiple sclerosis treated with ocrelizumab in a US community MS center: an observational study}, volume = {3}, number = {2}, elocation-id = {e000108}, year = {2021}, doi = {10.1136/bmjno-2020-000108}, publisher = {BMJ Specialist Journals}, abstract = {Background To monitor long-term outcomes of ocrelizumab treatment.Objective To evaluate safety and treatment outcomes of ocrelizumab in a community-based multiple sclerosis (MS) population.Methods Adult patients with MS prescribed ocrelizumab were eligible. Chart reviews were conducted at the start of ocrelizumab treatment and every 6 months thereafter.Results Of the 355 patients enrolled, 71.9\% were female; mean (SD) age was 51.8 (12.5) years; 78.3\% had relapsing MS (RMS). Median baseline Expanded Disability Status Scale (EDSS) (IQR) was 3.0 (2.0{\textendash}4.0) for RMS, 6.5 (6.0{\textendash}7.5) for secondary progressive MS, and 6.5 (6.0{\textendash}7.0) for primary progressive MS. Respiratory infections occurred in 40.1\% and urinary tract infections in 33.1\% of patients. There was no difference in the percentage of infections among patients \<55 (68.5\%, n=122), and those >=55 of age (67.5\%, n=104) (p=0.94). Twenty-five hospitalisations were due to infections; 69.2\% of these patients were >=55 with a mean EDSS of 5.7 ({\textpm}1.86). Four patients have died. Serum IgM and IgG levels did not predict infection risk. Annualised relapse rate was 0.34 for the patients with RMS in the preceding 2 years and 0.09 in patients who received >=2 ocrelizumab 600 mg courses. The first on-treatment MRI was stable in 262 (90.0\%) patients, 6.9\% had new T2 lesions, 2.7\% had enlarging T2 lesions and 1.4\% had gadolinium-enhancing lesions. Median EDSS at 12 months was unchanged.Conclusion Ocrelizumab effectively controlled relapse risk and disability worsening. Although only 12.1\% of patients have discontinued ocrelizumab, infections resulting in hospitalisation are a concern, especially in older and disabled patients.Data are available upon reasonable request.}, URL = {https://neurologyopen.bmj.com/content/3/2/e000108}, eprint = {https://neurologyopen.bmj.com/content/3/2/e000108.full.pdf}, journal = {BMJ Neurology Open} }