Related Experiment Video
Updated: Jun 14, 2026
An Ex vivo Model of an Oligodendrocyte-directed T-Cell Attack in Acute Brain Slices
Published on: February 5, 2015
Disease outcomes following lateral switch among different CD20-antibodies in active multiple sclerosis
Franziska Axhausen1, Anne Mrochen1, Pia Winter1
1Department of Neurology, University Hospital Giessen and Marburg, Justus-Liebig-University Giessen, Giessen, Germany.
Background:
Ocrelizumab (OCR) and ofatumumab (OFA)are approved and their differences in dosing route and interval allow personalized treatment. However, there are no data on whether lateral switches between both substances affect treatment effectiveness or safety.
Methods:
We screened our local cohort of MS patients, who began OCR since 09/2020 or OFA since 09/2021. Patients with a lateral switch were matched to controls who continuously received initial B-cell depleting therapy (BCT). We compared disease courses including effectiveness outcomes as well as peripheral CD19+ B-cell counts and serum IgG levels.
Results:
From 09/2020 to 03/2024, 713 patients were subjected to BCT (OCR: 396; OFA: 317 [as in Fig.1]). The matched OCR cohort included 38 switchers and 149 controls. The OFA cohort consisted of 24 switchers and 83 controls. Effectiveness outcomes were comparable among switchers and controls. B cell depletion appeared slightly pronounced following a switch. Serum IgG levels declined faster among switchers compared to controls (OCR: 9.7 vs 9.0 g/L; p = 0.007; manifest hypogammaglobulinemia (HGG) in 13.2% vs 6.0%; OFA: 9.7 vs 8.4 g/L; p = 0.016; manifest HGG in 8.3% vs 2.4%).
Conclusions:
Lateral switching between BCT does not abate effectiveness in this matched real-world cohort. Our observation of increased loss of IgG warrants further validation, but may indicate niche-specific immunological effects of OFA and OCR.
Insights
Switching between ocrelizumab (OCR) and ofatumumab (OFA) for multiple sclerosis (MS) maintains treatment effectiveness. However, switching may lead to faster IgG decline and increased hypogammaglobulinemia risk.
Area of Science:
- Immunology
- Neurology
- Pharmacology
Background:
- Ocrelizumab (OCR) and ofatumumab (OFA) are approved B-cell depleting therapies for multiple sclerosis (MS).
- Differences in dosing and administration allow for personalized MS treatment strategies.
- Limited data exist on the safety and efficacy of switching between OCR and OFA.
Purpose of the Study:
- To evaluate the effectiveness and safety of switching between OCR and OFA in MS patients.
- To compare disease activity, B-cell counts, and immunoglobulin G (IgG) levels in patients who switched therapies versus those who did not.
Main Methods:
- A retrospective analysis of MS patients treated with OCR or OFA was conducted.
- Patients who switched between OCR and OFA (switchers) were matched to controls who received continuous initial B-cell therapy.
- Effectiveness outcomes, CD19+ B-cell counts, and serum IgG levels were compared between switchers and controls.
Main Results:
- Effectiveness outcomes were similar between switchers and controls for both OCR and OFA cohorts.
- B-cell depletion was slightly more pronounced after switching therapies.
- Switchers showed a faster decline in serum IgG levels, with a higher incidence of hypogammaglobulinemia (HGG) compared to controls.
Conclusions:
- Lateral switching between OCR and OFA does not compromise treatment effectiveness in MS patients.
- Increased IgG loss observed in switchers warrants further investigation into potential niche-specific immunological effects of these therapies.
More Related Videos
09:38Determining Immune System Suppression versus CNS Protection for Pharmacological Interventions in Autoimmune Demyelination
Published on: September 12, 2016
09:41Imaging CD19+ B Cells in an Experimental Autoimmune Encephalomyelitis Mouse Model using Positron Emission Tomography
Published on: January 20, 2023
