30.01.2024
Ocrelizumab reduces cortical and deep grey matter loss compared to the S1P-receptor modulator in multiple sclerosis, Bajrami et. al., 2024
Kurzfassung
Diese Studie verglich die Auswirkungen von Ocrelizumab (OCR) und Fingolimod (FGL) auf Patienten mit Multipler Sklerose (MS), wobei der Schwerpunkt auf deren Einfluss auf die Atrophie der kortikalen und tiefen grauen Substanz lag. Die Ergebnisse zeigen, dass OCR wirksamer darin war, die Anzahl neuer Läsionen der weißen Substanz zu reduzieren und den Verlust des Volumens der tiefen grauen Substanz im Vergleich zu FGL zu verlangsamen. Dies deutet darauf hin, dass eine frühe und gezielte Behandlung mit OCR die neurodegenerativen Komponenten der MS signifikant mildern könnte, was zu besseren Langzeitergebnissen für die Patienten führen könnte.
Published in
Journal of Neurology
Autoren
A. Bajrami, A. Tamanti, A. Peloso, S. Ziccardi, M. Guandalini, M. Calderone, M. Catellaro, F. B. Pizzini, S. Montemezzi, D. Marastoni, M. Calabrese
Abstract
Introduction
Ocrelizumab (OCR) and Fingolimod (FGL) are two high-efficacy treatments in multiple sclerosis which, besides their strong anti-inflammatory activity, may limit neurodegeneration.
Aim:
To compare the effect of OCR and FGL on clinical and MRI endpoints.
Methods:
95 relapsing–remitting patients (57 OCR, 38 FGL) clinically followed for 36 months underwent a 3-Tesla MRI at baseline and after 24 months. The annualized relapse rate, EDSS, new cortical/white matter lesions and regional cortical and deep grey matter volume loss were evaluated.
Results:
OCR reduced the relapse rate from 0.48 to 0.04, FGL from 0.32 to 0.05 (both p < 0.001). Compared to FGL, OCR-group experienced fewer new white matter lesions (12% vs 32%, p = 0.005), no differences in new cortical lesions, lower deep grey matter volume loss (− 0.12% vs − 0.66%; p = 0.002, Cohen’s d = 0.54), lower global cortical thickness change (− 0.45% vs − 0.70%; p = 0.036; d = 0.42) and reduced cortical thinning/volume loss in several regions of interests, including those of parietal gyrus (d-range = 0.65–0.71), frontal gyrus (d-range = 0.47–0.60), cingulate (d-range = 0.41–0.72), insula (d = 0.36), cerebellum (cortex d = 0.72, white matter d = 0.44), putamen (d = 0.35) and thalamus (d = 0.31). The effect on some regional thickness changes was confirmed in patients without focal lesions.
Conclusion:
When compared with FGL, patients receiving OCR showed greater suppression of focal MRI lesions accumulation and lower cortical and deep grey matter volume loss.