BackgroundThe use of anti-CD20 drugs has become a widespread therapeutic approach in systemic and central nervous system (CNS) neuroinflammation. Apart from the desired B-cell depletion, relevant dynamics of the humoral and cellular immune response occur.
Despite the extensive utilization of these drugs, direct comparative analyses of various B-cell-depleting agents remain scarce.MethodsA total of 262 patients with neuroimmunological diseases treated with ocrelizumab, ofatumumab, or rituximab were observed over a median period of 36 months. Relapses, infection rates, and the concentration of immunoglobulins were monitored quarterly.
In addition, changes in cellular immunity (differential blood count, natural killer cells, CD19+, CD3+, CD4+, and CD8+ cells) along with polyclonal T-cell function (measured by reactivity) were analyzed using multidimensional flow cytometry.ResultsAnnual relapse rates in both the ocrelizumab and ofatumumab groups were low: 0.11 [95 % confidence interval (CI), 0.06 – 0.15] and 0.08 (95% CI, 0.05 – 0.16), respectively. Infections occurred significantly less frequently with ofatumumab (p < 0.001).
Hypogammaglobulinemia was observed more frequently and earlier in rituximab patients (p < 0.001).
Frontiers in Immunology published a clinical update in Infectious Disease on 12 May 2026.
The item focuses on Real-world comparison of anti-CD20 therapies: efficacy, infections, and immune profiles in a German cohort.
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