The following is a summary of “Ocrelizumab reduces cortical and deep grey matter loss compared to the S1P-receptor modulator in multiple sclerosis,” published in the January 2024 issue of Neurology by Bajrami et al.
Ocrelizumab (OCR) and Fingolimod (FGL), while effective in suppressing inflammation in multiple sclerosis (MS), may also hold promise in protecting against neurodegeneration.
Researchers conducted a retrospective study comparing the impact of OCR and FGL on clinical and MRI endpoints.
They clinically followed 95 relapsing–remitting patients (57 treated with OCR, 38 with FGL for 36 months, subjecting them to a 3-Tesla MRI at baseline and after 24 months. Relapse rate, EDSS, new lesions, and cortical/grey matter loss were evaluated.
The results showed OCR decreased the relapse rate from 0.48 to 0.04, while FGL reduced it from 0.32 to 0.05 (P<0.001). The OCR group exhibited fewer new white matter lesions than FGL (12% vs 32%, P=0.005) and no differences in new cortical lesions. Additionally, the OCR group experienced lower deep grey matter volume loss (− 0.12% vs − 0.66%; P=0.002, Cohen’s d =0.54) and lower global cortical thickness change (− 0.45% vs − 0.70%; P=0.036; d=0.42). Moreover, there was reduced cortical thinning/volume loss in various regions of interest, including the 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 regional thickness changes was confirmed in patients without focal lesions.
They concluded that compared to FGL, OCR displayed superior control over MRI lesion growth and neurodegeneration in cortical and deep grey matter.
Source: link.springer.com/article/10.1007/s00415-023-12179-y