多発性硬化症患者のオクレリズマブ誘発性ニュートロペニア:単一センター研究
Arianna Sartori1, Anna Favero1, Lucrezia Rossi1
1Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Strada Di Fiume, 447 34149, Trieste, Italy.
Multiple sclerosis and related disorders
|August 22, 2025
まとめ
多発性硬化症に対するオクレリズマブ (OCR) 治療は,患者の20%以上で中性不全を引き起こす可能性があります. ニュートロフィルの基準値は,この状態のリスクのある患者を予測するのに役立ちます.
科学分野:
- 神経科学
- 免疫学
- 薬理学について
背景:
- オクレリズマブ (OCR) を含むCD20減少剤は,多発性硬化症 (MS) の治療に使用されます.
- ニュートロペニアはこれらの治療の既知の合併症ですが,その流行率はよく確立されていません.
- OCRによるMS患者の管理には,中性不全の頻度を理解することが重要です.
研究 の 目的:
- オクレリズマブ (OCR) で治療された多発性硬化症 (pwMS) の患者における中性不全の頻度を決定する.
- OCR治療中に中性不全を発症させる危険因子を特定する.
主な方法:
- OCRを受信する74 pwMSの将来の登録.
- 白血球 (WBC) と絶対中性粒子の数 (ANC) に焦点を当てた臨床および検査データの収集
- ニュートロペニアの定義は,ANC < 2 × 10^3/μL である.
主要な成果:
- ニュートロペニアはpwMSの21. 9% (16/ 73) で発生し,グレード2〜4のニュートロペニアは7例であった.
- ニュートロペニアは,第2回のOCRサイクル後に最も多く見られた.
- ベースラインのANCとWBCは中性不全の発生を予測した.
- ニュートロペニアのエピソードでは細菌感染は観察されなかった.
結論:
- オクレリズマブに関連した中性不全は,患者の20%以上に影響します.
- ほとんどの症例は無症状で感染はありませんでした.
- 初期白血球とANCは,中性不全のリスクのある患者を特定するための重要な指標です.
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