Experience of using anti-CD 20 therapies in multiple sclerosis patients in Kenya

Area of Science:

• Neuroimmunology
• Pharmacology
• Clinical Neurology

Background:

• Multiple Sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
• B-cell-depleting therapies, such as ocrelizumab and rituximab, have emerged as significant treatment options for MS.
• Real-world data on the safety and efficacy of these therapies in African populations are limited.

Purpose of the Study:

• To evaluate the safety and efficacy of ocrelizumab (OCR) and rituximab (RTX) in a cohort of patients with multiple sclerosis.
• To assess the impact of these anti-CD20 therapies on clinical relapse rates and magnetic resonance imaging (MRI) disease activity.
• To provide real-world evidence on B-cell-depleting therapy outcomes in an African MS registry.

Main Methods:

• A retrospective, single-centre study was conducted at Aga Khan University Hospital Nairobi, Kenya.
• Adult patients (18-65 years) diagnosed with MS according to McDonald 2017 criteria and treated with ocrelizumab or rituximab between January 2016 and June 2025 were included.
• Data on demographics, disease characteristics, treatment history, adverse events, clinical relapses, and MRI findings were collected and analyzed.

Main Results:

• Sixty-seven patients received anti-CD20 therapy, predominantly with relapsing-remitting MS (RRMS).
• After one year, a significant reduction in the cumulative relapse rate was observed, decreasing from 48 to 7 patients experiencing clinical relapses.
• No infusion-related adverse events, serious infections, malignancies, or progressive multifocal encephalopathy (PML) were reported.
• Forty patients maintained stable MRI findings, while seven showed new lesions; 20 patients lacked follow-up scans.

Conclusions:

• Ocrelizumab and rituximab demonstrate favorable safety and tolerability profiles in this African MS cohort.
• These B-cell-depleting agents are effective in reducing disease activity, evidenced by decreased relapse rates and stable MRI findings.
• The study provides valuable real-world data supporting the use of ocrelizumab and rituximab as therapeutic options for individuals with MS in Kenya.