From the Research
Elective procedures can generally be performed on patients with multiple sclerosis (MS) who are on ublituximab, but careful consideration and planning are necessary, as supported by the most recent study in 2024 1. The timing of the procedure should ideally be coordinated with the patient's neurologist and surgeon.
Key Considerations
- It's recommended to schedule elective procedures at least 4-6 weeks after the last ublituximab infusion when possible, as this allows some recovery of B-cell counts and reduces infection risk.
- For urgent procedures, the benefits may outweigh the risks of proceeding without delay.
- Preoperative assessment should include complete blood count, liver function tests, and screening for infections.
- Ublituximab is an anti-CD20 monoclonal antibody that depletes B-cells and can potentially increase infection risk and impair wound healing, as noted in a study from 2022 2.
- The medication has a half-life of approximately 32 days, so its immunosuppressive effects persist for weeks after administration.
Postoperative Care
- Postoperatively, patients should be monitored closely for infections, and prophylactic antibiotics may be considered based on the procedure type.
- The next scheduled dose of ublituximab may need to be delayed until adequate wound healing has occurred, typically 2-4 weeks after the procedure, depending on its complexity.
Recent Study Findings
- A systematic review and network meta-analysis of randomized trials from 2024 found that there is no statistically significant difference between ublituximab and other monoclonal antibodies in terms of clinical efficacy 1.
- The study also showed that there is no statistically significant difference in discontinuation rates with the exception of the comparison with alemtuzumab.
- Another study from 2023 discussed the main findings obtained during the phase 3 clinical trials (ULTIMATE I and II) for ublituximab versus teriflunomide, highlighting the emergence and approval of new anti-CD20 mAbs with different dose regimens, routes of application, glycoengineering, and mechanisms of action 3.