Debunking Myths About Wearing Off Effect of DMTs for MS: Ilya Kister, MD

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"The bottom line is that we did not see any difference in the score that patients gave for their symptoms whether that’s early or later on. Again, it’s preliminary data, we’re still analyzing and there might be other subsets of patients who react differently. But, the findings are surprising and go against the general feeling about the subject from the community."

At the 37th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), October 13-15, investigators presented the SYMBOLS study, a trial looking at a possible “wearing-off” effect of ocrelizumab (Ocrevus; Genentech), an FDA-approved therapy for multiple sclerosis (MS) administered at 6-month intervals. This prospective, observational, study measured symptom burden using NeuroQol, SymptoMScreen, and Work Productivity and Activity Impairment at weeks 4, 12, and 22 after each infusion for each of the 2 infusion cycles.

Preliminary data from the study, which included 69 patients who completed the week 4 and 22 questionnaires, showed no changes in symptom burden post-infusion for both time points. In the same timeframe, of the 12 Neuro-QoL short forms, the only significant change in symptoms was a marginal improvement in the sleep disturbance domain toward the end of the cycle (P = .052). Overall, the findings did not support the hypothesis of a wearing-off phenomenon with ocrelizumab.

In an interview with NeurologyLive, senior author Ilya Kister, MD, professor of neurology, NYU Grossman School of Medicine, discussed the level of concern for clinicians about such a wearing-off effect, the findings presented at ECTRIMS, and the clinical significance of this data, which goes against traditional expectations.

REFERENCE

Jungquist RM, Malik M, Rimler Z, et al. Is there ‘wearing-off’ with ocrelizumab? Preliminary results of SYMptom burden on ocrelizumab, a longitudinal study (SYMBOLS). Presented at ECTRIMS 2021; October 13-15.