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News
For newly diagnosed MS patients, B-cell-depleting therapies (BCDTs) dramatically outperformed oral treatments on relapse rates and brain lesion growth. But after 2 years, disability scores looked virtually the same across all treatment groups. The findings, from the pan-European MultipleMS study of 509 patients, suggest that curbing acute inflammation doesn't automatically translate to slowing long-term disability progression.
For newly diagnosed MS patients, not all therapies are created equal — at least when it comes to relapses. A prospective pan-European study of 509 treatment-naive adults found that B-cell-depleting therapies (BCDTs) like rituximab and ocrelizumab were associated with a 62% lower relapse rate and reduced T2 brain lesion volume compared to oral platform therapies like dimethyl fumarate and teriflunomide over 2 years. BCDTs also had the highest treatment adherence, with nearly 94% of patients staying on their initial therapy.
But the picture gets more complicated when it comes to disability. Despite their edge on inflammatory markers, BCDTs and high-efficacy therapies showed no significant advantage over oral treatments in Expanded Disability Status Scale (EDSS) scores or serum neurofilament light chain (sNfL) levels at 2 years — suggesting that controlling acute inflammation may not be enough to halt the slower, smoldering progression of MS.
By the Numbers
Why it matters: These real-world findings highlight a critical gap: current high-efficacy MS therapies excel at suppressing relapses but may fall short against the chronic, compartmentalized CNS inflammation that drives long-term disability. Emerging agents like BTK inhibitors and anti-CD40L monoclonal antibodies may offer a new path forward.
