Abstract
BACKGROUND: Anti-CD20 therapy is a highly effective multiple sclerosis (MS) disease-modifying therapy, but may be complicated by infections, which has led to the utilization of different extended interval dosing (EID) regimens. OBJECTIVES: To compare the efficacy and safety of standard interval dosing (SID) and EID of anti-CD20 therapy in MS. METHODS: We searched PubMed and MS conference abstracts and included all studies comparing distinct cohorts of people with MS (PwMS) treated with SID and EID of anti-CD20 therapy that reported ≥1 efficacy or safety outcome measure. A meta-analysis was performed with effect size calculation (log odds ratio [logOR]) of efficacy and safety outcome measures. RESULTS: Seventeen studies comparing SID to EID were identified, with 1739 (SID) and 1856 (EID) participants. There was no significant difference in frequencies of PwMS with relapses (logOR = 0.15; p = 0.37), MRI activity (logOR = 0.05; p = 0.7), no evidence of disease activity -3 (logOR = 0.33; p = 0.33), serious infections (logOR = 0.46; p = 0.16), and hypogammaglobulinemia G (logOR = -0.24; p = 0.76). CONCLUSIONS: Data from observational studies suggests that EID of anti-CD20 therapy may have a comparable efficacy and safety profile compared to SID.