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Updated: Jan 22, 2026

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在多发性硬化症中停止使用ocrelizumab:疾病活动的复发
Franz Felix Konen1, Franziska Axhausen2, Stephanie Wolff2
1Department of Neurology, Hannover Medical School, Hanover, Germany.
Journal of neurology, neurosurgery, and psychiatry
|January 20, 2026
概括
30个月后在多发性硬化症 (MS) 患者中停止使用ocrelizumab似乎是短期安全的. 然而,由于可能延迟MS复激活,在治疗后两年内密切监测至关重要.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 临床试验 临床试验
背景情况:
- 在患有多发性硬化症 (pwMS) 患者中,停止使用像ocrelizumab这样的B细胞耗尽疗法的最佳策略尚不清楚.
- 人们担心疾病复发延迟,残疾进展以及停药前适当的治疗持续时间.
研究的目的:
- 在pwMS中评估停止使用ocrelizumab后的疾病复发和残疾恶化.
- 通过ROC分析来确定停止使用ocrelizumab治疗之前的最佳持续时间.
主要方法:
- 前性,两中心观察队列研究与倾向性得分匹配 (PSM) 分析.
- 在2018年1月至2023年12月期间注册的pwMS (≥12个月的ocrelizumab,前12个月没有活动)
- 评估时间到联合炎症活动 (CIA) 和不依赖复发活动的进展 (PIRA).
主要成果:
- 在中位数为28.5个月的随访后,停药者和继续使用者之间在CIA或PIRA风险上没有显著差异.
- 停药后24个月后,疾病活动保持稳定,没有统计学上显著的增加.
- ROC分析表明,最佳治疗持续时间约为29-30个月,治疗结束后>32个月后复激活风险增加.
结论:
- 在大约30个月的治疗后停止使用ocrelizumab似乎是稳定的pwMS的短期安全.
- 建议在停止使用ocrelizumab后的两年内进行警监测,因为可能会延迟疾病的重新激活.
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