Related Experiment Video
Updated: Sep 13, 2025
A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
Published on: December 9, 2015
Treatment outcomes in multiple sclerosis using reduced and extended interval ocrelizumab dosing
Antonia McLean1, Simon Arnett1, Joshua Yap1
1Department of Neurology, Gold Coast University Hospital, Southport QLD 4215, Australia.
Background:
People with multiple sclerosis (pwMS) treated with ocrelizumab at our tertiary hospital during the COVID-19 pandemic were exposed to reduced dosing of 300 mg (RD) every 6 months, and also extended interval dosing (EID), due to concerns around infection risk and challenges attending hospital. We analysed clinical, MRI and laboratory outcomes to assess treatment effectiveness and safety compared with standard dosing (SD).
Methods:
We collected data retrospectively on all people treated with ocrelizumab through our MS clinic from 01/01/2018 to 01/01/2024. Dates and dosage of ocrelizumab; expanded disability status score; clinical relapse; MRI brain and spine lesions; circulating B cells and immunoglobulin levels were collated. Annualised relapse risk and other parameters were calculated over time.
Results:
A total of 113 pwMS were eligible for inclusion in the analysis. 76 pwMS received RD ocrelizumab, and 21 had EID. We found no significant difference in the clinical or radiological outcomes between the SD, RD or EID treatment regimens. During the follow-up period one person had a relapse just prior to EID at 9 months, and one had a relapse while on SD. B-cell repopulation prior to the subsequent dose occurred more frequently during EID compared with SD. There was a non-significant trend to higher immunoglobulin levels with RD and EID regimens compared with SD.
Conclusions:
Reduced exposure to ocrelizumab in pwMS, through RD or EID, did not result in significant differences in clinical or radiological outcomes in our population. This real-world single centre study supports further prospective exploration of these strategies.
Insights
Reduced ocrelizumab dosing for multiple sclerosis (MS) patients showed similar clinical and radiological outcomes compared to standard dosing. This suggests modified ocrelizumab regimens are safe and effective for pwMS.
Area of Science:
- Neurology
- Immunology
- Pharmacology
Background:
- Ocrelizumab dosing was modified during the COVID-19 pandemic for people with multiple sclerosis (pwMS) due to infection risk and hospital access challenges.
- Reduced dosing (RD) and extended interval dosing (EID) were implemented, deviating from standard dosing (SD).
- The study aimed to compare the effectiveness and safety of these modified regimens against SD.
Purpose of the Study:
- To evaluate the clinical and radiological outcomes of reduced ocrelizumab dosing (RD) and extended interval dosing (EID) in pwMS.
- To assess the safety profile of modified ocrelizumab dosing strategies.
- To compare these outcomes with standard dosing (SD) in a real-world setting.
Main Methods:
- Retrospective data collection from 113 pwMS treated with ocrelizumab between 01/01/2018 and 01/01/2024.
- Analysis of clinical relapse, MRI lesions, B cells, and immunoglobulin levels.
- Calculation of annualized relapse risk and comparison across SD, RD, and EID groups.
Main Results:
- No significant differences in clinical or radiological outcomes were observed between SD, RD, and EID regimens.
- B-cell repopulation occurred more frequently with EID compared to SD.
- A non-significant trend towards higher immunoglobulin levels was noted with RD and EID.
Conclusions:
- Modified ocrelizumab dosing strategies (RD and EID) did not compromise clinical or radiological outcomes in pwMS.
- These findings support the potential efficacy and safety of reduced ocrelizumab exposure.
- Further prospective studies are warranted to explore these dosing strategies in MS management.
Related Concept Videos
01:24Rational Dosage Regimen: Maintenance Dose and Loading Dose
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady...
01:01Dosage Regimen: Fixed Dose
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
01:15Drug Dosage Regimen: Overview
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
01:24Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF