Exploring the “wearing-off” effect toward the end of treatment cycles
More than half of people with MS who take monoclonal antibody disease-modifying therapies (DMTs) experience a “wearing-off” effect shortly before they are due for the next dose of their medication, according to researchers from the Mellen Center for Multiple Sclerosis at the Cleveland Clinic.2
Those researchers surveyed 258 people, including 154 who were receiving Ocrevus® (ocrelizumab), 39 receiving Kesimpta® (ofatumumab), 37 receiving Tysabri® (natalizumab), and 28 receiving Rituxan® (rituximab). (Rituxan is not approved for the treatment of MS in the United States, although it is approved to treat several other conditions. Some clinicians use it “off-label” for multiple sclerosis.)
The researchers also found an association between this “wearing-off phenomenon” and an elevated risk for depression. They identified the link by having study participants complete the Patient Health Questionnaire 9 (PHQ9), a self-administered diagnostic instrument for common emotional health disorders. Higher scores on the test are indicative of depression. The investigators found that each additional point on a person’s PHQ9 score added 2% to the odds that he or she experienced a wearing-off of treatment effects, with that association being statistically significant. Not surprisingly, the wearing-off phenomenon was also associated with diminished treatment satisfaction.
This study validates what many people with MS report to their clinicians. It also highlights an important counseling point to share with people taking monoclonal antibody DMTs. While the study wasn’t designed to answer the question of whether the “wearing-off phenomenon” contributes to depression or whether pre-existing depression heightens awareness of a medication’s diminishing effectiveness, it does provide further reason to screen for and treat depression in people with MS. Finally, while this wearing-off effect is obviously unwelcome, it serves to demonstrate that DMTs are having enough of an impact that people notice when they are near the end of their treatment cycle and ready for their next dose.
https://mymsaa.org/news/whats-new-in...ch-march-2024/
More than half of people with MS who take monoclonal antibody disease-modifying therapies (DMTs) experience a “wearing-off” effect shortly before they are due for the next dose of their medication, according to researchers from the Mellen Center for Multiple Sclerosis at the Cleveland Clinic.2
Those researchers surveyed 258 people, including 154 who were receiving Ocrevus® (ocrelizumab), 39 receiving Kesimpta® (ofatumumab), 37 receiving Tysabri® (natalizumab), and 28 receiving Rituxan® (rituximab). (Rituxan is not approved for the treatment of MS in the United States, although it is approved to treat several other conditions. Some clinicians use it “off-label” for multiple sclerosis.)
The researchers also found an association between this “wearing-off phenomenon” and an elevated risk for depression. They identified the link by having study participants complete the Patient Health Questionnaire 9 (PHQ9), a self-administered diagnostic instrument for common emotional health disorders. Higher scores on the test are indicative of depression. The investigators found that each additional point on a person’s PHQ9 score added 2% to the odds that he or she experienced a wearing-off of treatment effects, with that association being statistically significant. Not surprisingly, the wearing-off phenomenon was also associated with diminished treatment satisfaction.
This study validates what many people with MS report to their clinicians. It also highlights an important counseling point to share with people taking monoclonal antibody DMTs. While the study wasn’t designed to answer the question of whether the “wearing-off phenomenon” contributes to depression or whether pre-existing depression heightens awareness of a medication’s diminishing effectiveness, it does provide further reason to screen for and treat depression in people with MS. Finally, while this wearing-off effect is obviously unwelcome, it serves to demonstrate that DMTs are having enough of an impact that people notice when they are near the end of their treatment cycle and ready for their next dose.
https://mymsaa.org/news/whats-new-in...ch-march-2024/