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Infusion of ocrelizumab at home is feasible and safe for patients with multiple sclerosis, with patients expressing greater satisfaction and preference for this method over previous infusion center experiences.

Multiple sclerosis (MS) treatments frequently necessitate routine and continuous therapy for optimal treatment of the disease, including disease-modifying therapy such as ocrelizumab infusions. Ocrelizumab, a humanized recombinant monoclonal antibody that selectively targets CD20-expressing B cells, is approved for the treatment of both relapsing MS (RMS) and primary progressive MS (PPMS), and is infused in two 300 mg doses separated by two weeks. 

However, there is inadequate data on the safety of home-based infusions, particularly in MS. 

A study published in the journal Annals of Clinical and Translational Neurology aimed to evaluate safety and patient satisfaction for at-home ocrelizumab administration for patients with MS.

Patient Statistics and Hallmarks of Disease

In this home infusion cohort trial, 99 patients with MS were included in the ITT population. The study included patients with RMS (95.8%) and PPMS (4.2%). The mean (±SD) disease duration and the number of prior infusions were 70.1 (± 346.9) months and 5.6 (± 1.9) infusions, respectively. Around 20% of the participants had Patient-Determined Disease Steps (PDDS) scores of 3 or higher, indicating significant disability. The median and interquartile range (IQR) for the Expanded Disability Status Scale (EDSS) was 2.00 [1.50-3.00].

Procedures for Home-Based Ocrelizumab Infusion Administration

Before their ocrelizumab infusion, the majority of patients were administered acetaminophen (94.9%), methylprednisolone (89.9%), and diphenhydramine (88.9%).

The overall mean (SD) infusion time for this cohort was 2.5 (0.6) hours, with 75.8% of patients experiencing an infusion period of > 2 to 2.5 hours.

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Infusion-Related Reactions With Ocrelizumab Infusions Administered at Home

Only 25.3% of patients experienced an infusion-related reaction (IRR) of any grade during the at-home ocrelizumab infusion. These IRRs were 18.2% for Grade 1  and 7.1% for Grade 2; no IRRs were classified as Grade 3.

Patient-Reported Adverse Events Associated With At-Home Infusion

A total of 174 adverse events (AEs) were reported among these patients, with 66.7% experiencing adverse events with at-home ocrelizumab infusions. Itching was the most common reported AE, followed by fatigue, grogginess, pain, headache or migraine, and gastrointestinal AEs. However, no significant adverse events were recorded following the infusion.

Patient Compliance With Home-Based Ocrelizumab Treatment

Favorable scores were reported across patient-reported outcome measures of their at-home infusion experience, with significant improvements compared to their prior infusion experience at an infusion center. After home infusion, patients also reported satisfaction with being treated with courtesy by their infusion nurse. 

 

Source

Barrera, B., Simpson, H., Engebretson, E., Sillau, S., Valdez, B., Parra-González, J., Winger, R. C., Epperson, L. A., Banks, A., Pierce, K., Spotts, M., O’Gean, K., Alvarez, E., Gross, R., Piquet, A. L., Schreiner, T., Corboy, J. R., Pei, J., Vollmer, T. L., & Nair, K. V. (2023). Safety and patient experience with at‐home infusion of ocrelizumab for multiple sclerosis. Annals of Clinical and Translational Neurology, 10(4), 579–588. https://doi.org/10.1002/acn3.51745