Advances in the treatment of multiple sclerosis through monoclonal antibody Ocrelizumab
DOI:
https://doi.org/10.11606/issn.2176-7262.v53i1p35-41Keywords:
Multiple Sclerosis, Antibody, DiagnosisAbstract
Objective: Evaluating the effectiveness and risks associated with the treatment of multiple sclerosis with the monoclonal antibody Ocrelizumab.
Methods: The study consists of a narrative review that aimed to search articles evidencing the effects of the Ocrelizumab drug for the recurrent and primary progressive forms of multiple sclerosis. The search was carried out in PubMed, BVS, Cochrane Library, and ScienceDirect databases from 2011. The articles were pre-selected through the title and abstract for full reading and included or excluded in the study according to predetermined criteria.
Results: A total of 743 articles were retrieved, 23 of which were considered eligible for comprehensive analysis and 20 were excluded because they did not fit into the outcomes proposed. Three studies were included. All studies have demonstrated the high efficacy of Ocrelizumab free of opportunistic infections.
Conclusion: Despite the degenerative nature of MS, technological advances in therapy through drugs such as Ocrelizumab bring promising results, such as reduced annual outbreak rates, the number of MRI injuries, and the progress of the disability. However, due to its recent approval, it is not possible to evaluate the long-term effects of monoclonal antibody use.
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References
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13. Dendrou CA, Fugger L, Friese MA. Immunopathology of multiple sclerosis. Nature Reviews Immunology, 2015;15(9):545-58. doi: 10.1038/nri3871
14. Filippini G. Ocrelizumab appears to reduce relapse and disability in multiple sclerosis but quality of evidence is moderate. Evid Based Med. 2017;22(6):215–6. doi: 10.1136/ebmed-2017-110721
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16. Thompson AJ, Banwell BL, Barkhof F, Carroll WM, Coetzee T, Comi G. Diagnosis of multiple sclerosis: revisions of the McDonald criteria. The Lancet Neurology. 2018;17(2):162-73. doi: 10.1016/S1474-4422(17)30470-2.
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18. Polman CH, O’Connor PW, Havrdova E, Hutchinson M, Kappos L, Miller DH. A randomized, placebo-controlled trial of natalizumab for relapsing multiple sclerosis. N Engl J Med. 2006;354:899-910. doi: 10.1056/NEJMoa044397
19. Rudick RA, Stuart WH, Calabresi PA, Confavreux C, Galetta SL, Radue EW. Natalizumab plus interferon beta-1a for relapsing multiple sclerosis. N Engl J Med. 2006;354:911-23. doi: 10.1056/NEJMoa044396
20. Fernández O, Fernández VE, Guerrero M. Tratamiento de la esclerosis múltiple. Med. 2015;11(77):4622-33. doi: https://doi.org/10.1016/j.med.2015.04.001
21. ANVISA (2017). Esclerose múltipla tem novo tratamento aprovado. Recuperado de: http://portal.anvisa.gov.br/rss/-/asset_publisher/Zk4q6UQCj9Pn/content/id/4097328. Citado em 03 Dezembro 2018.
22. Kappos L, Li D, Calabresi PA, O’Connor P, Bar-Or A, Barkhof F. Ocrelizumab in relapsing-remitting multiple sclerosis: a phase 2, randomised, placebo-controlled, multicentre trial. Lancet. 2011;378(9805):1779-87. doi: 10.1016/S0140-6736(11)61649-8.
23. ROCHE (2018) Ocrevus® (ocrelizumabe). Recuperado de: https://www.dialogoroche.com/content/dam/brasil/bulas/o/ocrevus/Bula-OCREVUS-Profissional.pdf Citado em 03 Dezembro 2018.
24. Hauser SL, Bar-Or A, Comi G, Giovannoni G, Hartung H-P, Hemmer B. Ocrelizumab versus Interferon Beta-1a in Relapsing Multiple Sclerosis. N Engl J. Med. 2017;376(3):221–34. doi: 10.1056/NEJMoa1601277.
25. Montalban X, Hauser SL, Kappos L, Arnold DL, Bar-Or A, Comi G. Ocrelizumab versus Placebo in Primary Progressive Multiple Sclerosis. N Engl J Med. 2017;376:209-220. doi: 10.1056/NEJMoa1606468
26. Li H, Hu F, Zhang Y, Li K. Comparative efficacy and acceptability of disease-modifying therapies in patients with relapsing–remitting multiple sclerosis: a systematic review and network meta-analysis. J Neurol. 2019. doi:10.1007/s00415-019-09395-w
2. Dargahi N, Katsara M, Tselios T, Androutsou ME, Courten M, Matsoukas J, et al. Multiple sclerosis: Immunopathology and treatment update. Brain Sciences. 2017;7(7):78. doi: 10.3390/brainsci7070078
3. Ministério da Saúde (2014). Pesquisa com dados do DATASUS sobre mobilidade em pacientes com esclerose múltipla é um dos destaques do 15o Encontro Anual de Esclerose Múltipla BCTRIMS .Recuperado de: http://datasus.saude.gov.br/noticias/atualizacoes/506-pesquisa-com-dados-do-datasus sobre-mobilidade-em-pacientes-com-esclerose-multipla-e-um-dos-destaques-do-15-encontro-anual-de-esclerose-multipla-bctrims-2014. Citado em 03 Dezmbro 2018.
4. DCNI (2016). Recomendações no Tratamento da Esclerose Múltipla e Neuromielite Óptica. Recuperado de :http://formsus.datasus.gov.br/novoimgarq/28121/4880987_312361.pdf
Citado em 03 Dezembro 2018.
5. Huang WJ, Chen WW, Zhang X. Multiple sclerosis: Pathology, diagnosis and treatments. Experimental and therapeutic Medicine. 2017;13(6):3163–66. doi: 10.3892/etm.2017.4410
6. Syed YY. Ocrelizumab: A Review in Multiple Sclerosis. CNS Drugs. 2018;2(9):883–90. doi: 10.1007/s40263-018-0568-7.
7. Yang H, Duchesneau E, Foster R, Guerin A, Ma E, Thomas NP. Cost effectiveness analysis of ocrelizumab versus subcutaneous interferon beta-1ª for the treatment of relapsing multiple sclerosis. J Med Econ. 2017;20(10):1056-65. doi: 10.1080/13696998.2017.1355310.
8. Menge T, Dubey D, Warnke C, Hartung H-P, Stüve O, Menge T, et al. Ocrelizumab for the treatment of relapsing-remitting multiple sclerosis. Expert Rev Neurother. 2016;16(10):1131-9. doi: 10.1080/14737175.2016.1227242
9. Howard J, Trevick S, Younger DS. Epidemiology of Multiple Sclerosis. Neurologic Clinics. 2016;34(4):919-39. doi: 10.1016/j.ncl.2016.06.016
10. Ciccarelli O, Barkhof F, Bodini B, Stefano N, Golay X, Nicolay K. Pathogenesis of multiple sclerosis : insights from molecular and metabolic imaging. Lancet Neurol. 2014;13(8):807–22. doi: 10.1016/S1474-4422(14)70101-2
11. Garg N, Smith TW. An update on immunopathogenesis, diagnosis, and treatment of multiple sclerosis. Brain Behav. 2015;5(9):1–13. doi:10.1002/brb3.362
12. Alves B, Angeloni R, Azzalis L, Pereira E, Perazzo F, Rosa P, et al. Esclerose múltipla: revisão dos principais tratamentos da doença. Saúde E Meio Ambiente: Revista Interdisciplinar. 2015;3(2):19-34. doi: https://doi.org/10.24302/sma.v3i2.542
13. Dendrou CA, Fugger L, Friese MA. Immunopathology of multiple sclerosis. Nature Reviews Immunology, 2015;15(9):545-58. doi: 10.1038/nri3871
14. Filippini G. Ocrelizumab appears to reduce relapse and disability in multiple sclerosis but quality of evidence is moderate. Evid Based Med. 2017;22(6):215–6. doi: 10.1136/ebmed-2017-110721
15. Ministério da Saúde (2018). Protocolo Clínico e Diretrizes Terapêuticas da Esclerose Múltipla. Recuperado de: http://portalarquivos2.saude.gov.br/images/pdf/2018/abril/09/PORTARIA- Citado em 03 Dezembro 2018.
16. Thompson AJ, Banwell BL, Barkhof F, Carroll WM, Coetzee T, Comi G. Diagnosis of multiple sclerosis: revisions of the McDonald criteria. The Lancet Neurology. 2018;17(2):162-73. doi: 10.1016/S1474-4422(17)30470-2.
17. Silva VM, Nascimento VMS. Esclerose Múltipla : Imunopatologia , Diagnóstico e Tratamento. Interfaces Científicas - Saúde e Ambient. 2014;2(3):81–90.
18. Polman CH, O’Connor PW, Havrdova E, Hutchinson M, Kappos L, Miller DH. A randomized, placebo-controlled trial of natalizumab for relapsing multiple sclerosis. N Engl J Med. 2006;354:899-910. doi: 10.1056/NEJMoa044397
19. Rudick RA, Stuart WH, Calabresi PA, Confavreux C, Galetta SL, Radue EW. Natalizumab plus interferon beta-1a for relapsing multiple sclerosis. N Engl J Med. 2006;354:911-23. doi: 10.1056/NEJMoa044396
20. Fernández O, Fernández VE, Guerrero M. Tratamiento de la esclerosis múltiple. Med. 2015;11(77):4622-33. doi: https://doi.org/10.1016/j.med.2015.04.001
21. ANVISA (2017). Esclerose múltipla tem novo tratamento aprovado. Recuperado de: http://portal.anvisa.gov.br/rss/-/asset_publisher/Zk4q6UQCj9Pn/content/id/4097328. Citado em 03 Dezembro 2018.
22. Kappos L, Li D, Calabresi PA, O’Connor P, Bar-Or A, Barkhof F. Ocrelizumab in relapsing-remitting multiple sclerosis: a phase 2, randomised, placebo-controlled, multicentre trial. Lancet. 2011;378(9805):1779-87. doi: 10.1016/S0140-6736(11)61649-8.
23. ROCHE (2018) Ocrevus® (ocrelizumabe). Recuperado de: https://www.dialogoroche.com/content/dam/brasil/bulas/o/ocrevus/Bula-OCREVUS-Profissional.pdf Citado em 03 Dezembro 2018.
24. Hauser SL, Bar-Or A, Comi G, Giovannoni G, Hartung H-P, Hemmer B. Ocrelizumab versus Interferon Beta-1a in Relapsing Multiple Sclerosis. N Engl J. Med. 2017;376(3):221–34. doi: 10.1056/NEJMoa1601277.
25. Montalban X, Hauser SL, Kappos L, Arnold DL, Bar-Or A, Comi G. Ocrelizumab versus Placebo in Primary Progressive Multiple Sclerosis. N Engl J Med. 2017;376:209-220. doi: 10.1056/NEJMoa1606468
26. Li H, Hu F, Zhang Y, Li K. Comparative efficacy and acceptability of disease-modifying therapies in patients with relapsing–remitting multiple sclerosis: a systematic review and network meta-analysis. J Neurol. 2019. doi:10.1007/s00415-019-09395-w
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Published
2020-04-27
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1.
Silva JG da, Pezzini MF, Poeta J. Advances in the treatment of multiple sclerosis through monoclonal antibody Ocrelizumab. Medicina (Ribeirão Preto) [Internet]. 2020 Apr. 27 [cited 2024 May 19];53(1):35-41. Available from: https://www.revistas.usp.br/rmrp/article/view/161404
