OPERA I OPERA II (Pooled)a Incidence Rate per 100 Patient-Years (95% CI) |
ORATORIOb Incidence Rate per 100 Patient-Years (95% CI) |
|||
---|---|---|---|---|
IFN β-1a | Ocrelizumab | Placebo | Ocrelizumab | |
Phase III Controlled Treatment Period | 0.14 (0.02-0.52) | 0.07 (0-0.38) | 0.41 (0.08-1.20) | 0.25 (0.07-0.64) |
a Two identical Phase III, global, randomised, double-blind, double-dummy studies with a 96-week controlled period during which 1656 patients with relapsing forms of MS received either intravenous ocrelizumab (600 mg) every 24 weeks or subcutaneous interferon beta-1a (44 μg) three times weekly.5
b A Phase III, global, randomised, double-blind study with a ≥120-week controlled period during which 732 patients with primary progressive MS received either intravenous ocrelizumab (600 mg) or placebo every 24 weeks.6
Data Cutoff Datea | Patients on Ocrelizumab (n) | Patient-Years | Fatalities (n) | Incidence Rate per 100 Patient-Years | 95% CIs | |
---|---|---|---|---|---|---|
Ocrelizumab All-Exposure |
JUL 2015 | 2,147 | 4,484.5 | 8 | 0.178 | 0.077-0.352 |
JAN 2016 | 2,279 | 5,710.7 | 8 | 0.140 | 0.060-0.276 | |
SEP 2016 | 2,300 | 6,940.9 | 11 | 0.158 | 0.079-0.284 | |
FEB 2017 | 2,301 | 7,747.8 | 13 | 0.168 | 0.089-0.287 | |
SEP 2017 | 3,778 | 9,473.5 | 16 | 0.169 | 0.097-0.274 | |
FEB 2018 | 3,811 | 10,918.5 | 17 | 0.156 | 0.091-0.249 | |
JUL 2018 |
4,501 |
12,558.9 |
19 | 0.151 |
0.091-0.236 | |
JAN 2019 | 4,611 | 14,328.5 | 23 | 0.161 | 0.102-0.241 |
a Data cuts are cumulative; each data cut includes the previous cut and fatalities are included from both the controlled treatment period and open-label extension.
b Includes all patients exposed to ocrelizumab in the global and US MS clinical trials; excludes patients in compassionate use programme.
The causes of the fatalities in the all-exposure population are as follows: Suicide (n=5), cardiac arrest (n=2), metastatic pancreatic cancer (n=2), pneumonia (n=2), acute coronary insufficiency (n=1), adenocarcinoma of oesophagus (n=1), aspiration pneumonia (n=1), bladder cancer (n=1), epileptic seizure (n=1), injury (n=1), MS disease progression (n=1), pulmonary embolism (n=1), systemic inflammatory response syndrome of undetermined origin (n=1), unknown (n=1), urinary infection/urosepsis (n=1) and fall (n=1).
Market Perioda | Patients on Ocrelizumabb | Patient-Years | Fatalities (n)c | Incidence Rate per 100 Patient-Years | |
---|---|---|---|---|---|
Ocrelizumab Post-Marketing | APR 2017–DEC 2017 |
~27,678 |
~8,899 |
24 | 0.27 |
APR 2017–MAR 2018 |
~37,171 |
~15,682 |
45 | 0.29 | |
APR 2017–MAY 2018 |
~48,780 |
~23,776 |
64 | 0.27 | |
APR 2017–JULY 2018 |
~58,667 |
~33,526 |
87 | 0.26 | |
APR 2017–SEP 2018 |
~66,662 |
~43,560 |
114 | 0.26 | |
APR 2017–DEC 2018 |
~78,554 |
~60,710 |
149 | 0.25 | |
APR 2017–MAY 2019 |
~103,290 | ~94,964 | 250 | 0.26 | |
APR 2017–JULY 2019 | ~114,943 | ~111,166 | 293 | 0.26 | |
APR 2017–DEC 2019 |
~142,855 | ~159,317 | 433 |
0.27 |
a Numbers reported for the marketing period are inclusive of the whole month stated.
b The number of post-marketing patients exposed to ocrelizumab is based on estimated total number of vials sold, as well as US claims data.
c Based on reported fatalities in the Roche safety database in patients treated with ocrelizumab within the designated post-marketing period.
The causes of the post-marketing fatalities are as follows: Unknown cause (n=247), myocardial infarction (n=15), completed suicide (n=13), pneumonia (n=10), sepsis (n=10), pulmonary embolism (n=6), pancreatic cancer (n=4), fall (n=4), lung cancer (n=3), infection (n=3), MS (n=3), sudden death (n=3), urosepsis (n=3), aspiration pneumonia (n=3), cardiac arrest (n=3), cardiac disorder (n=2), urinary tract infection (n=2), subdural hematoma (n=2), victim of homicide (n=2), renal failure (n=2), colon cancer (n=2), metastatic renal cell carcinoma (n=2), urinary tract infection with sepsis (n=2), head injury (n=2), septic shock (n=2), symptoms reported as a cause of death (pyrexia, chest pain, and decreased appetite) (n=1), tumefactive MS (n=1), MS relapse (n=1), MS relapse with infection (n=1), MS relapse with influenza-like illness (n=1), cerebral hemorrhage (n=1), cerebral hemorrhage and subdural hemorrhage (n=1), opioid overdose (n=1), bacterial pneumonia with lactic acidosis and sepsis (n=1), acute kidney injury (n=1), influenza (n=1), influenza-like illness (n=1), brain herniation with toxic leukoencephalopathy (n=1), cardiogenic shock with circulatory collapse and urinary tract infection (n=1), epilepsy with status epilepticus (n=1), cellulitis with pneumonia, sepsis, and urinary tract infection (n=1), aspiration pneumonia with respiratory failure (n=1), metastatic lung cancer (n=1), acute respiratory failure with urosepsis (n=1), acute respiratory failure with pneumonia (n=1), dyspnea (n=1), cardiopulmonary arrest with pulmonary embolism and deep vein thrombosis (n=1), sepsis with aspiration pneumonia, intestinal sepsis, cardiac arrest, and intestinal obstruction (n=1), lung infection (n=1), lung infection with osteomyelitis (n=1), choking (n=1), stroke (n=1), cardiac failure congestive (n=1), cardiac failure with nephropathy (n=1), respiratory failure (n=1), encephalopathy, seizure, and respiratory failure (n=1), cardiorespiratory arrest (n=1), adenocarcinoma (n=1), aspiration and septic shock (n=1), cardiac failure (n=1), lung disorder (n=1), fracture (n=1), peritonitis (n=1), aortic aneurysm (n=1), myocardial infarction with cardiac failure and cardiac disorder (n=1), cardiac arrest with pulmonary embolism (n=1), hemorrhage (n=1), hepatic and renal failure (n=1), kidney infection (n=1), metastatic neoplasm (n=1), liver cancer (n=1), breast cancer (n=1), sudden death and metastatic neoplasm (n=1), respiratory disorder (n=1), respiratory distress (n=1), respiratory failure, multiple organ dysfunction syndrome, and circulatory collapse (n=1), generalized edema (n=1), thrombosis (n=1), sarcoma (n=1), angiosarcoma (n=1), acute promyelocytic leukemia (n=1), adult failure to thrive (n=1), cardiac failure, MS, and hypotension (n=1), acute kidney injury, hepatic cirrhosis, ascites, and hepatorenal syndrome (n=1), amyotrophic lateral sclerosis (n=1), anaphylactic shock (n=1) arteriovenous fistula site hemorrhage (n=1), cerebrovascular accident (n=1), circulatory collapse (n=1), glioblastoma (n=1), glioblastoma multiforme (n=1), intestinal dilatation with sepsis (n=1), lip and/or oral cavity cancer and throat cancer (n=1), malignant melanoma (n=1), multiple organ dysfunction syndrome with sepsis (n=1), myelodysplastic syndrome (n=1), metastatic non-small cell lung cancer (n=1), pancreatic cancer with cardiopulmonary arrest and pleural effusion (n=1), post-procedural pulmonary embolism (n=1), procedural complication (n=1), pulmonary mass (n=1), pulmonary edema and pulmonary hemorrhage (n=1), road traffic accident (n=1), ruptured cerebral aneurysm (n=1), seizure (n=1), septic shock with atrial fibrillation and brain injury (n=1), accident (n=1), and sleep apnea syndrome (n=1).
Le indicazioni variano da un paese all'altro. Le informazioni posologiche per il proprio paese rappresentano la principale fonte di informazioni in merito ai rischi noti e potenziali associati all'uso dell'ocrelizumab.
OCR/032218/0083b(7)