Abstract Details

Title Infection Rates Associated with Anti-CD20 Treatment In Pediatric Onset Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) S7 - Multiple Sclerosis: Special Populations and Non-MS CNS Neuroinflammatory Disease (4:30 PM-4:42 PM)

Poster/Presentation
Number 006

Background Approximately 5% of MS patients experience symptoms under age 18 years, termed Pediatric Onset Multiple Sclerosis (POMS). Disease-Modifying Therapies that act on CD positive 20 cells, e.g. rituximab and ocrelizumab, are effective for relapse prevention in POMS. The limitation of anti-CD20 treatment is the risk of infection associated with B-cell depletion.

Objective

To describe frequency and type of infections in a single-center cohort of 91 POMS patients on anti-CD20 therapy.

Design/Methods

A retrospective chart review of 91 POMS from NYU Langone Pediatric MS Center was conducted. Inclusion criteria: MS onset < 18 years, RRMS subtype, anti-CD20 therapy > 12 months (rituximab, ocrelizumab, or both). Infection information was obtained from the medical records. Mild infections were defined as infections not requiring antibiotics. Moderate infections were defined as infections requiring oral antibiotics. Severe infections were defined as infections requiring intravenous antibiotics or hospitalization. Demographics, medical history, and laboratory values were also obtained.

Results POMS mean age was 22.00 years, range (11-31) with a mean MS disease duration of 8.33 years, range (1.76-24.10). A total of 41/91 (45.05%) patients reported any infection, including urinary tract infection 12/91 (13.19%), pneumonia 5/91(5.49%), sinusitis 4/91 (4.40%) and skin infection 4/91 (4.40%). 11/91 (12.09%) of patients had mild infections, 24/91 (26.37%) had moderate infections, and 6/91 (6.59%) had severe infections. On average, patients with severe infections were older (26.50 years vs. 21.75 years, p=.012), had longer CD20 treatment duration (5.20 years vs. 4.76 years, p=.041), and longer MS disease duration (13.26 years vs. 8.05 years, p=.008) when compared to patients with either mild or no infections.

Conclusions Risk of severe infections was associated with increasing patient age, MS disease duration, and CD20 treatment duration. Understanding the risk factors associated with CD20-associated infections in the POMS population can help optimize treatment and counsel patients and families appropriately.

Authors/Disclosures
Lauren Seidman PRESENTER	Miss Seidman has nothing to disclose.
Nadine Azmy	No disclosure on file
Anna Sosa	No disclosure on file
Ugo Nwigwe	No disclosure on file
Kimberly O'Neill, MD	Dr. O'Neill has nothing to disclose.
Lauren B. Krupp, MD, FAAN (NYU Langone Medical Center)	Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gerson Lerhman. Dr. Krupp has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for medscape. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NeuroLive. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Krupp has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for Cleveland Clinic. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for MCIC. The institution of Dr. Krupp has received research support from Biogen. The institution of Dr. Krupp has received research support from National Multiple Sclerosis Society. Dr. Krupp has received intellectual property interests from a discovery or technology relating to health care.