Evidence map›Paper›PMID 35581005›Full record

ArticleNeurology(R) neuroimmunology & neuroinflammation2022

Transitioning From S1P Receptor Modulators to B Cell-Depleting Therapies in Multiple Sclerosis: Clinical, Radiographic, and Laboratory Data.

William M Rowles, Wan-Yu Hsu, Kira McPolin, Alyssa Li, Steven Merrill, Chu-Yueh Guo, Ari J Green, Jeffrey Marc Gelfand, Riley M Bove

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology(R) neuroimmunology & neuroinflammation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. The Art of Sequencing Disease-Modifying Therapies in Multiple Sclerosis.Neurology(R) neuroimmunology & neuroinflammation · 2026
    Review
  4. Article
  5. Article
  6. Article
  7. Review
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

William M RowlesFrom the UCSF Weill Institute for Neurosciences (W.M.R., W.-Y.H., K.M., A.L., C.-Y.G., A.J.G., J.M.G., R.M.B.), Division of Neuroimmunology and Glial Biology, Department of Neurology, Department of Clinical Pharmacy (S.M.), and UCSF Department of Ophthalmology (A.J.G.), University of California, San Francisco.ORCID 0000-0002-5613-0483
Wan-Yu HsuFrom the UCSF Weill Institute for Neurosciences (W.M.R., W.-Y.H., K.M., A.L., C.-Y.G., A.J.G., J.M.G., R.M.B.), Division of Neuroimmunology and Glial Biology, Department of Neurology, Department of Clinical Pharmacy (S.M.), and UCSF Department of Ophthalmology (A.J.G.), University of California, San Francisco.
Kira McPolinFrom the UCSF Weill Institute for Neurosciences (W.M.R., W.-Y.H., K.M., A.L., C.-Y.G., A.J.G., J.M.G., R.M.B.), Division of Neuroimmunology and Glial Biology, Department of Neurology, Department of Clinical Pharmacy (S.M.), and UCSF Department of Ophthalmology (A.J.G.), University of California, San Francisco.
Alyssa LiFrom the UCSF Weill Institute for Neurosciences (W.M.R., W.-Y.H., K.M., A.L., C.-Y.G., A.J.G., J.M.G., R.M.B.), Division of Neuroimmunology and Glial Biology, Department of Neurology, Department of Clinical Pharmacy (S.M.), and UCSF Department of Ophthalmology (A.J.G.), University of California, San Francisco.
Steven MerrillFrom the UCSF Weill Institute for Neurosciences (W.M.R., W.-Y.H., K.M., A.L., C.-Y.G., A.J.G., J.M.G., R.M.B.), Division of Neuroimmunology and Glial Biology, Department of Neurology, Department of Clinical Pharmacy (S.M.), and UCSF Department of Ophthalmology (A.J.G.), University of California, San Francisco.
Chu-Yueh GuoFrom the UCSF Weill Institute for Neurosciences (W.M.R., W.-Y.H., K.M., A.L., C.-Y.G., A.J.G., J.M.G., R.M.B.), Division of Neuroimmunology and Glial Biology, Department of Neurology, Department of Clinical Pharmacy (S.M.), and UCSF Department of Ophthalmology (A.J.G.), University of California, San Francisco.
Ari J GreenFrom the UCSF Weill Institute for Neurosciences (W.M.R., W.-Y.H., K.M., A.L., C.-Y.G., A.J.G., J.M.G., R.M.B.), Division of Neuroimmunology and Glial Biology, Department of Neurology, Department of Clinical Pharmacy (S.M.), and UCSF Department of Ophthalmology (A.J.G.), University of California, San Francisco.
Jeffrey Marc GelfandFrom the UCSF Weill Institute for Neurosciences (W.M.R., W.-Y.H., K.M., A.L., C.-Y.G., A.J.G., J.M.G., R.M.B.), Division of Neuroimmunology and Glial Biology, Department of Neurology, Department of Clinical Pharmacy (S.M.), and UCSF Department of Ophthalmology (A.J.G.), University of California, San Francisco.ORCID 0000-0002-5121-3319
Riley M BoveFrom the UCSF Weill Institute for Neurosciences (W.M.R., W.-Y.H., K.M., A.L., C.-Y.G., A.J.G., J.M.G., R.M.B.), Division of Neuroimmunology and Glial Biology, Department of Neurology, Department of Clinical Pharmacy (S.M.), and UCSF Department of Ophthalmology (A.J.G.), University of California, San Francisco. riley.bove@ucsf.edu.ORCID 0000-0002-2034-8800
Dr. M.G.R. Educational and Research Institute · IN

Funding

The Role of B cells in the Origin and Progression of Multiple SclerosisR35NS111644 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI STEPHEN L HAUSER · 2019 to 2026
$9.1M
NINDS NIH HHS R35 NS111644
6 · The paper itself

Abstract

BACKGROUND AND

objectivesPatients with multiple sclerosis (MS) transition from oral sphingosine-1-receptor (S1P) modulators to anti-CD20 therapies for several circumstances. Optimal timing of this transition is uncertain, given competing concerns of rebound disease activity and ensuring immune reconstitution. The objective of this study was to evaluate the relationship between inflammatory activity and the transition period from fingolimod to anti-CD20 therapies in a real-world MS cohort.

methodsMedical records were reviewed for all patients at our center transitioning from fingolimod to rituximab or ocrelizumab between 2010 and October 2020. Time periods reviewed were the following: before fingolimod discontinuation, interval between fingolimod and anti-CD20 treatments, and after the first anti-CD20 infusion. The primary outcome was clinical relapses; MRI activity, time to absolute lymphocyte count (ALC) recovery, and infections were secondary. Clinical and demographic factors significant in univariable analyses were included in multivariable analyses.

resultsTransition data were available for 108 patients (68.5% women, 68.5% relapsing-remitting MS, mean age 44.6 years). The median (interquartile range) interval between fingolimod and anti-CD20 therapy was 28 (1-115.2) days. Six of 51 patients (11.8%) with intervals >1 month and 0/57 patients with shorter intervals experienced a relapse (MRI confirmed) within 6 months of fingolimod discontinuation. In the year following anti-CD20 initiation, 4/108 patients (3.7%) experienced a relapse (median 214.5 days after infusion). An additional 7% of those undergoing contrast-enhanced MRIs developed Gd+ lesions. ALC normalized following treatment switch in 89/92; the interval between treatments was unrelated to ALC recovery or infection. DISCUSSION: Delaying anti-CD20 start to monitor ALC after S1P modulator discontinuation may not be necessary and could increase rebound risk. ALC monitoring could instead occur after a rapid switch to anti-CD20 treatment.

Indexed as

Multiple SclerosisMultiple Sclerosis, Relapsing-RemittingAdultAntigens, CD20FemaleFingolimod HydrochlorideHumansMaleRecurrenceSphingosine-1-Phosphate ReceptorsAntigens, CD20Fingolimod HydrochlorideSphingosine-1-Phosphate Receptors

Identifiers

PMID35581005
PMCPMC9128034
OpenAlexW4280552541

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.