The Use of Ocrelizumab in Pediatric Multiple Sclerosis Patients in the United Arab Emirates: A Retrospective Study

• Published in: Multiple sclerosis and related disorders 2023-03, Vol.71, p.104280, Article 104280
• Main Authors: Atieh, Mutaz Iyad, Riachi, Naji Joseph, Kumar, Palat Chirakkara, Shatila, Ahmed Osman
• Format: Article
• Language: English
• ISSN: 2211-0348; 2211-0356
• DOI: 10.1016/j.msard.2022.104280

The humanized anti-CD20 monoclonal antibody, Ocrelizumab, is approved for use only in adults with Relapsing-Remitting Multiple Sclerosis (RRMS). When compared to Interferon Beta-1a, its efficacy was shown to be higher with reduced disease activity, decreased rate of relapses, and delayed disability progression. Currently, a phase 2 clinical trial named ‘A study of Ocrelizumab in Children and Adolescents with Relapsing-Remitting Multiple Sclerosis’ is enrolling pediatric patients in the United States, Italy, and Poland This is a retrospective study approved by the Research Ethics Committee in Sheikh Shakhbout Medical City, Abu Dhabi; U.A.E. Ocrelizumab was administered to five pediatric RRMS patients under the age of 18. One patient completed three doses, and four patients completed two doses of the medication. The parameters screened include demographics, age at diagnosis, weight, height, menstrual status, treatment naïve or not, DMDs taken previously, hematological and biochemical values, EDSS, MRI before and after Ocrelizumab and school performance after Ocrelizumab infusion. The data are summarized in Tables 1 and 2. After Ocrelizumab infusions, the complete blood count, total and differential leukocyte count, vitamin D, and a metabolic panel, including renal and liver function tests, were within normal limits. School performance, as reported by patients’ families and the patients themselves, was improved in 60% and stable in 40%. All of the patients improved clinically with improved EDSS score, reported no side effects. While 4/5 patients had stable or improved MRI, the MRI in patient 5 showed new lesions after five months of the first dose of Ocrelizumab and is considered as the new baseline MRI. In this retrospective study on the use of Ocrelizumab in the pediatric population, we report a favorable outcome. The results obtained support the use of Ocrelizumab in pediatric patients. However, in view of our findings, further studies using different designs and protocols with larger numbers of patients are indicated to assess the usefulness of Ocrelizumab in the pediatric MS population.