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- Title
Ocrelizumab reduces cortical and deep grey matter loss compared to the S1P-receptor modulator in multiple sclerosis.
- Authors
Bajrami, Albulena; Tamanti, Agnese; Peloso, Angela; Ziccardi, Stefano; Guandalini, Maddalena; Calderone, Milena; Castellaro, Marco; Pizzini, Francesca B.; Montemezzi, Stefania; Marastoni, Damiano; Calabrese, Massimiliano
- Abstract
Introduction: Ocrelizumab (OCR) and Fingolimod (FGL) are two high-efficacy treatments in multiple sclerosis which, besides their strong anti-inflammatory activity, may limit neurodegeneration. Aim: To compare the effect of OCR and FGL on clinical and MRI endpoints. Methods: 95 relapsing–remitting patients (57 OCR, 38 FGL) clinically followed for 36 months underwent a 3-Tesla MRI at baseline and after 24 months. The annualized relapse rate, EDSS, new cortical/white matter lesions and regional cortical and deep grey matter volume loss were evaluated. Results: OCR reduced the relapse rate from 0.48 to 0.04, FGL from 0.32 to 0.05 (both p < 0.001). Compared to FGL, OCR-group experienced fewer new white matter lesions (12% vs 32%, p = 0.005), no differences in new cortical lesions, lower deep grey matter volume loss (− 0.12% vs − 0.66%; p = 0.002, Cohen's d = 0.54), lower global cortical thickness change (− 0.45% vs − 0.70%; p = 0.036; d = 0.42) and reduced cortical thinning/volume loss in several regions of interests, including those of parietal gyrus (d-range = 0.65–0.71), frontal gyrus (d-range = 0.47–0.60), cingulate (d-range = 0.41–0.72), insula (d = 0.36), cerebellum (cortex d = 0.72, white matter d = 0.44), putamen (d = 0.35) and thalamus (d = 0.31). The effect on some regional thickness changes was confirmed in patients without focal lesions. Conclusions: When compared with FGL, patients receiving OCR showed greater suppression of focal MRI lesions accumulation and lower cortical and deep grey matter volume loss.
- Subjects
MULTIPLE sclerosis; WHITE matter (Nerve tissue); CEREBRAL cortical thinning; ANTI-inflammatory agents; THALAMUS
- Publication
Journal of Neurology, 2024, Vol 271, Issue 5, p2149
- ISSN
0340-5354
- Publication type
Article
- DOI
10.1007/s00415-023-12179-y