Abstract
Objective
: To examine differences in the therapeutic response to ocrelizumab in multiple sclerosis
(MS) patients who self-identified as either White or Black, assessed longitudinally
by Expanded Disability Status Scale (EDSS) progression and MRI brain volume loss.
Methods
: MS subjects treated with ocrelizumab were retrospectively identified. Clinical data
were available for 229 subjects (White 146; Black 83) and MRI data from for 48 subjects
(White 31; Black 17). Outcome measures were changes in the EDSS and brain volume over
time. EDSS were analyzed as raw scores, ambulatory (EDSS <5.0) vs. ambulatory with assistance (5.5 ≤ EDSS ≤ 6.5) status, and EDSS severity (< 3.0, 3.0-5.0,
and > 5.5 ≤ 6.5). General linear mixed model was used for statistical analysis. FreeSurfer
was used for volumetric analysis.
Results
: The Black cohort had overrepresentation of females (78% vs. 62%, p=0.013), lower
age (median, 45 (IQR 39-51) vs. 49 (38-58), p=0.08), lower Vitamin D levels (33 (21-45) vs. 40 (29-52), p=0.002), and higher EDSS (4 (2-6) vs. 2.5 (1-6), p=0.019). There was no progression of EDSS scores over the 2-year observation
period. The covariates with significant influence on the baseline EDSS scores were
older age, race, longer disease duration, prior MS treatment, and lower vitamin D
levels. No differences were observed between the racial groups over time in the cortical,
thalamic, caudate, putamen, and brainstem gray matter volumes nor in the cortical
thickness or total lesion volume.
Conclusion
: In this real-world clinical and radiological study, ocrelizumab treatment was highly
effective in stabilizing clinical and MRI measures of disease progression in Blacks
and Whites, despite higher baseline disability in the Black cohort.
Keywords
Abbreviations:
BMI (Body mass index), CNS (central nervous system), DMT (disease modifying therapy), EDSS (expanded disability status scale), IQR (interquartile range), MS (multiple sclerosis)To read this article in full you will need to make a payment
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Article info
Publication history
Accepted:
January 15,
2023
Received in revised form:
December 14,
2022
Received:
November 14,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier B.V.
