RT Journal Article
SR Electronic
T1 009 Predicting infection risk in multiple sclerosis patients treated with ocrelizumab: a retrospective cohort study
JF BMJ Neurology Open
JO BMJ Neurol Open
FD BMJ Publishing Group Ltd
SP A4
OP A4
DO 10.1136/bmjno-2021-ANZAN.9
VO 3
IS Suppl 1
A1 Seery, Nabil
A1 Sharmin, Sifat
A1 Li, Vivien
A1 Nguyen, Ai-Lan
A1 Meaton, Claire
A1 Atvars, Roberts
A1 Taylor, Nicola
A1 Tunnell, Kelsey
A1 Carey, Joh
A1 Marriott, Mark P
A1 Buzzard, Katherine A
A1 Ross, Izanne
A1 Dwyer, Chris
A1 Baker, Josephine
A1 Taylor, Lisa
A1 Springs, Kymble
A1 Kilpatrick, Trevor J
A1 Kalincik, Tomas
A1 Monif, Mastura
YR 2021
UL http://neurologyopen.bmj.com/content/3/Suppl_1/A4.2.abstract
AB Objective To examine factors determining risk of self-reported infections and antimicrobial use in patients receiving Ocrelizumab for MS.Methods Retrospective, observational cohort study conducted in Ocrelizumab-treated patients at the Royal Melbourne Hospital. The association of clinical and laboratory factors with self-reported infection rate and antimicrobial use were estimated using univariate and multivariable logistic regression models.Results 185 patients were included in the study, and 176 infections were reported in 89 patients (46.1%), and in 47 patients (25.3%) antimicrobial use was identified. In univariate analyses, a higher serum IgA was associated with reduced odds of infection (OR 0.44, 95% CI 0.25 - 0.76). In multivariable analyses, older age (OR 0.94, 95% CI 0.88 - 0.99), higher serum IgA (OR 0.37, 95% CI 0.17 - 0.80) and higher serum IgG (OR 0.81, 95% CI 0.67 - 0.99) were associated with reduced odds of infection. Older age (OR 0.85, 95% CI 0.75 - 0.96) and higher serum IgA (OR 0.23, 95% CI 0.07 - 0.79) were associated with reduced odds of antimicrobial use, whilst longer MS disease duration (OR 1.22, 95% CI 1.06 - 1.41) and higher EDSS (OR 1.99, 95% CI 1.02 - 3.86) were associated with increased odds of antimicrobial use.Conclusions Higher serum IgA, IgG and older age were associated with reduced odds of infection. Our findings highlight non-uniformity of infection risk in Ocrelizumab-treated MS patients, and substantiate the need to monitor immunoglobulin levels pre-treatment and whilst on therapy.