Early monitoring of B cells on Ocrelizumab may help to identify those at risk of adverse effects

By Chandni Radia, Lead Pharmacist Neurosciences, Imperial College Healthcare NHS Trust


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This project was the winner of the MS Academy MasterClass Project Award for Autumn 2020

All of our attendees carry out a piece of research in an area of MS clinical practice or treatment that interests them.

This snapshot, which won the MS9 project awards, gives you a quick idea of what they found and why. If you want to learn more, just click through to the full poster, or follow the links within the snapshot.

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To assess:

  • the impact of ocrelizumab infusions on B-cell counts
  • whether there is a correlation between B-cell counts and adverse effects such as infection


  • A sample of 170 people with MS receiving ocrelizumab were reviewed over an 18 month period.
  • There was a correlation between low B-cell counts and likelihood of infection, where lymphocyte counts, CD8 and NK cells showed no difference.

Key findings

  • At baseline, there was no difference in B-cell count between those who developed adverse effects and those who did not.
  • Those who developed infections had a significantly lower B-cell count.
    • This difference persisted after the second dose.
  • There was no difference in lymphocyte counts, CD8 or NK cells.
  • The most common infections were upper respiratory tract and urinary tract.

Core recommendations

  • Regular monitoring of B-cell counts rather than absolute lymphocyte counts, could be a method of identifying patients at risk of adverse effects following ocrelizumab.

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