Monitor immunoglobulin levels prior to ocrelizumab initiation

A Victorian study that aimed to identify risk factors for infection in patients with MS treated with ocrelizumab has found that higher serum IgA and IgG and older age were associated with reduced odds of infection.

The retrospective, observational cohort study involving 185 patients receiving ocrelizumab at the Royal Melbourne Hospital also found that longer MS disease duration and higher EDSS scores were associated with increased odds of antimicrobial use.

“Our findings highlight that infection risk is not uniform in patients with MS receiving ocrelizumab and substantiate the need to monitor immunoglobulin levels pre-treatment and whilst on therapy,” the study investigators concluded in CNS Drugs.

AAN annual meeting this week

The American Academy of Neurology (AAN) will be holding its Annual Scientific Meeting in a fully virtual format this weekend (April 17-22).  The meeting will include hot topics such as Neuro-COVID and also latest results from clinical trials including nerinetide for the treatment of acute ischemic stroke, atogepant for the preventive treatment of migraine and efgartigimod in the treatment of myasthenia gravis

Cochrane updates review on cervical dystonia

The first update since 2005 of a Cochrane systematic review of treatments for cervical dystonia has found no new evidence on the use of botulinum toxin type A and anticholinergics.

Based on the results of one evaluablestudy, the review concluded there was “very low‐certainty evidence” that Dysport, when compared with trihexyphenidyl, may improve symptoms of cervical dystonia, pain, and quality of life. The risk of adverse events such as dry mouth and memory issues, was increased in people taking trihexyphenidyl.

The authors said the findings aligned with the current clinical practice guidelines of the American Academy of Neurology affirming that “BtA is probably more efficacious and better tolerated than trihexyphenidyl.”