Contributions
Abstract: P1884
Type: Poster
Abstract Category: Late breaking news
Background: Multiple sclerosis (MS) is a chronic autoimmune disease targeting the central nervous system. The vast majority of MS patients using disease modifying treatment at the University Hospital of Umeå (NUS) are on rituximab. Rituximab is a monoclonal anti-CD20 antibody that effectively reduce MS inflammatory activity through B-lymphocyte depletion. Vitamin D affects the activity and maturation of several immune cell types and high 25-hydroxy-vitamin D (25[OH]D) levels have been associated with decreased inflammatory disease activity in MS. In recent years, paralleling the accumulating evidence for a protective effect of vitamin D, there has been an increase of vitamin D supplementation among MS patients at the Department of Neurology at NUS. There is a need for follow-up studies of this treatment approach since both vitamin D supplementation and rituximab are used off-label.
Objective: To study inflammatory activity and adverse effects in an MS population treated with rituximab, and whether 25(OH)D levels were associated with these outcomes.
Method: Data were collected retrospectively on MS patients treated with rituximab at NUS. The database included repeated (yearly) estimates of relapses, disability, the presence of side effects, magnetic resonance imaging (MRI), laboratory measures including 25(OH)D levels, and estimation of self-perceived health (SPH).
Results: In 272 MS patients with a mean follow-up of 43 months we identified 13 relapses during active rituximab treatment. New T2 lesions were seen in 1.3% (10 out of 792) of MRI examinations, and 0.25% (2 out of 785) of examinations showed contrast-enhancement. The relative absence of inflammatory activity precluded analyses of associations with 25(OH)D levels, which increased during the follow-up period (r=0.15, p< 0.001). There were significant correlations between vitamin D levels (last estimate) and SPH (r=0.18, p=0.041, n=130) and a negative correlation between vitamin D levels and C-reactive protein (r=-0.13, p=0.042). No association between 25(OH)D levels and side effects was found.
Conclusion: The inflammatory activity in this MS population treated with rituximab and - to a large extent - with vitamin D supplementation was extremely low. The addition of vitamin D supplementation to rituximab treatment in MS patients may have beneficial effects on MS inflammatory activity and perceived wellbeing.
Disclosure:
Johan Linden: nothing to disclose
Jonatan Salzer has received concultancy honoraria from the educational website Neuro-Compass.
Anders Svenningsson: nothing to disclose
Peter Sundström: nothing to disclose
Abstract: P1884
Type: Poster
Abstract Category: Late breaking news
Background: Multiple sclerosis (MS) is a chronic autoimmune disease targeting the central nervous system. The vast majority of MS patients using disease modifying treatment at the University Hospital of Umeå (NUS) are on rituximab. Rituximab is a monoclonal anti-CD20 antibody that effectively reduce MS inflammatory activity through B-lymphocyte depletion. Vitamin D affects the activity and maturation of several immune cell types and high 25-hydroxy-vitamin D (25[OH]D) levels have been associated with decreased inflammatory disease activity in MS. In recent years, paralleling the accumulating evidence for a protective effect of vitamin D, there has been an increase of vitamin D supplementation among MS patients at the Department of Neurology at NUS. There is a need for follow-up studies of this treatment approach since both vitamin D supplementation and rituximab are used off-label.
Objective: To study inflammatory activity and adverse effects in an MS population treated with rituximab, and whether 25(OH)D levels were associated with these outcomes.
Method: Data were collected retrospectively on MS patients treated with rituximab at NUS. The database included repeated (yearly) estimates of relapses, disability, the presence of side effects, magnetic resonance imaging (MRI), laboratory measures including 25(OH)D levels, and estimation of self-perceived health (SPH).
Results: In 272 MS patients with a mean follow-up of 43 months we identified 13 relapses during active rituximab treatment. New T2 lesions were seen in 1.3% (10 out of 792) of MRI examinations, and 0.25% (2 out of 785) of examinations showed contrast-enhancement. The relative absence of inflammatory activity precluded analyses of associations with 25(OH)D levels, which increased during the follow-up period (r=0.15, p< 0.001). There were significant correlations between vitamin D levels (last estimate) and SPH (r=0.18, p=0.041, n=130) and a negative correlation between vitamin D levels and C-reactive protein (r=-0.13, p=0.042). No association between 25(OH)D levels and side effects was found.
Conclusion: The inflammatory activity in this MS population treated with rituximab and - to a large extent - with vitamin D supplementation was extremely low. The addition of vitamin D supplementation to rituximab treatment in MS patients may have beneficial effects on MS inflammatory activity and perceived wellbeing.
Disclosure:
Johan Linden: nothing to disclose
Jonatan Salzer has received concultancy honoraria from the educational website Neuro-Compass.
Anders Svenningsson: nothing to disclose
Peter Sundström: nothing to disclose