To systematically compare the anti-CD20-targeting antibodies RTX, OCR, and OFA in terms of clinical events and laboratory findings in patients with specific neuroimmunological diseases, such as multiple sclerosis.
Key Findings:
Annual relapse rates were low for both ocrelizumab (0.11 [95% CI, 0.06 – 0.15]) and ofatumumab (0.08 [95% CI, 0.05 – 0.16]).
Infection rates were significantly lower with ofatumumab (p < 0.001).
Hypogammaglobulinemia was more frequent and occurred earlier in rituximab patients (p < 0.001).
Ocrelizumab reduced total lymphocyte proportion and increased CD3+ T cells, while ofatumumab raised the CD4/CD8 ratio.
Anti-CD20 antibodies did not affect T-cell reactivity after polyclonal stimulation.
Interpretation:
B-cell depletion is effective across different CD20 antibodies; however, variations in infection rates and hypogammaglobulinemia occurrence suggest the need for tailored treatment strategies based on individual patient responses.
Limitations:
The study was conducted at a single center, which may limit generalizability to broader populations.
The observational design may introduce biases not present in randomized controlled trials, potentially affecting the reliability of the findings.
Conclusion:
The findings highlight the effectiveness of B-cell depletion in neuroimmunological diseases and underscore the importance of considering individual patient responses to different anti-CD20 therapies for optimal treatment strategies.
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
