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Efficacy and safety of ocrelizumab in patients with relapsing-remitting multiple sclerosis with a suboptimal response to previous disease-modifying therapies (1-year interim results)

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paroxysmal neurological changes, and from the authors' knowledge a rare diagnosis of these patients.

doi:10.1016/j.jns.2019.10.1403

WCN19-1883

Journal of the Neurological Sciences 405S (2019) 105066 Poster Session 3

Efficacy and safety of ocrelizumab in patients with relapsing-remitting multiple sclerosis with a suboptimal response to previous disease-modifying therapies (1‑year interim results) P. Vermerscha, J.P. Eralinnab, R. Nicholasc, C. Oreja-Guevarad, A. Sivae, B. Van Wijmeerschf, H. Wiendlg, R. Buffelsh, R. Kuheljh, W. Weih, G.

Comii

aUniversity of Lille, Department of Neurology, Lille, France bNEO Research, Department of Neurology, Turku, Finland

cImperial College Healthcare NHS Trust and Imperial College London,

Department of Neurology, London, United Kingdom

d

Hospital Clinico San Carlos, Department of Neurology, Madrid, Spain

eIstanbul University, Cerrahpasa Faculty of Medicine, Cerrahpasa, Turkey fUniversity Hasselt and Rehabilitation & MS-Centre, Department of

Neurology, Overpelt, Belgium

gUniversity of Münster, Department of Neurology, Münster, Germany hF. Hoffmann-La Roche Ltd, na, Basel, Switzerland

i

Vita-Salute San Raffaele University, Department of Neurology, Milan, Italy Background

The aim of the prospective, multicentre, single-arm Phase IIIb CASTING study (NCT02861014) is to assess the efficacy/safety of ocrelizumab in patients with relapsing-remitting multiple sclerosis (RRMS) with a prior suboptimal response to disease-modifying therapy (DMT).

Objective

To report 1-year interim analyses of no evidence of disease activity (NEDA) in CASTING.

Methods

Patients (Expanded Disability Status Scale [EDSS] score ≤4.0; disease duration≤10 years; discontinued prior DMT of ≥6 months’ duration due to suboptimal disease control) received intravenous ocrelizumab 600 mg/24 weeks for 96 weeks. NEDA (absence of: protocol-defined relapses [PDR], 24-week confirmed disability progression [24W-CDP], T1 gadolinium-enhancing or new/enlarging T2 lesions [rebaselined at Week 8]) was assessed every 24 weeks in the modified intent-to-treat population (mITT; patients receiving any dose who discontinued early without a protocol-defined event were imputed as having an event if treatment discontinuation was for lack of efficacy/death; others were excluded).

Results

A total of 680 patients (female, 64%; mean [SD] baseline EDSS score, 2.1 [1.1]; disease duration, 5.0 [2.7] years; pretreated with one DMT, n=411 [60.5%]; pretreated with two DMTs, n=265 [39.5%]) were included in the interim mITT population. At Week 48, most patients had NEDA (n/N=586/674 [86.9%]). Rates of 24W-CDP (4.8%), PDR (4.2%), T1 gadolinium-enhancing (2.8%) and new/ enlarging T2 lesions (6.2%) were low. The adjusted annualised relapse rate was 0.048. Safety outcomes will be reported.

Conclusions

Most patients in CASTING had NEDA. Future CASTING data will describe additional efficacy/safety results of ocrelizumab treatment in patients who had ongoing disease activity while receiving another DMT.

doi:10.1016/j.jns.2019.10.1404

WCN19-1884

Journal of the Neurological Sciences 405S (2019) 105067 Poster Session 3

Vitamin 25(OH) D and cognitive function in parkinson’s disease M. Barichellaa, C. Bolliria, G. Pinellib, L. Iorioa, V. Ferria, E. Cassania, A.

Gianaa, S. Caronnia, C. Pusania, F. Del Sorboa, R. Ciliaa, E. Quaccia, G.

Riboldazzic, S. Lanfranchic, E. Ceredad, G. Pezzolia

aParkinson Institute- ASST G.Pini-CTO, ASST G.Pini-CTO, Milan, Italy bDipartimento Riabilitazione Malattia di Parkinson e Disturbi del

Movimento- Ospedale Classificato Moriggia Pelascini- Gravedona, Milan, Italy

cU.S. Riabilitazione Parkinson- Fondazione Gaetano e Piera Borghi di

Brebbia, Fondazione Gaetano e Piera Borghi, Brebbia, Italy

d

Clinical Nutrition and Dietetics Unit- Fondazione IRCCS Policlinico San Matteo- Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy Objective

The role of vitamin D is gaining attention in neurodegenerative diseases, as low serum concentrations have been consistently found in both Alzheimer’s and Parkinson’s disease (PD). This study aims to correlate 25(OH) D plasma levels with global cognitive function and severity of motor function in PD.

Methods

350 patients with idiopathic PD (66% male, mean age 70.5 yr (range 60-87), mean disease duration 9.9±5.7 yr) were consecu-tively recruited at a tertiary referral clinic during an 8-month period. We correlated plasma 25(OH) D levels with demographic and clinical data, including PD severity (Hoehn & Yahr stage) and global cognitive function (Mini Mental State Examination, MMSE) . In addition, Plasma 25(OH) D levels were correlated with sun exposure (hours/day).

Results

Overall, PD patients showed 25(OH) D deficiency (mean level 17.1 ± 8.34 ng/ml). Using simple linear correlation analysis, we found a direct association between 25(OH) D and MMSE score (p=0.03) and an inverse association between 25(OH) D and age (pb0.01) and the Hoehn & Yahr stage (p=0.01). Plasma 25(OH) D levels positively correlated with solar exposure (p = 0.04). Conclusion

In a large PD cohort, low 25(OH) D levels correlated with older age and with worse global cognitive function and disease severity. Daily time of sun exposure greatly increased 25(OH) D levels. We strongly recommend screening PD patients for 25(OH) D plasma levels and -in case of deficiency- ensuring oral supplementation to reduce the risk of cognitive dysfunction and motor disability. doi:10.1016/j.jns.2019.10.1405

Abstracts / Journal of the Neurological Sciences 405S (2019) 116542 310

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