Real-world comparison of anti-CD20 therapies: efficacy, infections, and immune profiles in a German cohort
By
Jakob Stögbauer
Moritz Bewarder
Linda Groß
Lorenz Thurner
Klaus Fassbender
Rebecca Urschel
Einar A. Høgestøl
Gro O. Nygaard
Hanne F. Harbo
Olaf Stüve
Marc Pawlitzki
Sven G. Meuth
Martina Sester
Sergiu Groppa
Mathias Fousse
May 12, 2026
Clinical Scorecard: Comparative Analysis of Anti-CD20 Treatments: Effectiveness, Infection Rates, and Immune Responses in a German Patient Population
At a Glance
Category Detail
Condition Neuroimmunological diseases Key Mechanisms B-cell depletion via anti-CD20 antibodies Target Population Patients with relapsing multiple sclerosis (RMS) and primary progressive multiple sclerosis (PPMS) Care Setting Neurology department at Saarland University Hospital
Key Highlights
Low annual relapse rates: 0.11 for ocrelizumab and 0.08 for ofatumumab Significantly lower infection rates with ofatumumab (p < 0.001) Hypogammaglobulinemia more frequent in rituximab patients (p < 0.001) Ocrelizumab linked to reduced total lymphocytes and increased CD3+ T cells Ofatumumab associated with a rise in CD4/CD8 ratio Guideline-Based Recommendations
Diagnosis
Monitor relapses and infections quarterly in patients treated with anti-CD20 therapies Management
Consider individualized treatment strategies based on immune response and infection rates, with rationale provided. Monitoring & Follow-up
Regular assessment of immunoglobulin levels and lymphocyte subpopulations, with specified monitoring frequency. Risks
Increased risk of infections and hypogammaglobulinemia associated with B-cell depletion therapy Patient & Prescribing Data
262 patients treated with ocrelizumab, ofatumumab, or rituximab
B-cell depletion is effective across different anti-CD20 therapies, but with varying infection risks, including specific rates.
Clinical Best Practices
Conduct thorough patient education on potential risks of infections Implement regular follow-ups to monitor immune responses and infection rates Utilize flow cytometry for detailed analysis of immune cell dynamics Related Resources & Content
