ArticleDiseases (Basel, Switzerland)2025
Immunological Monitoring During Anti-CD20 Therapies to Predict Infection Risk and Treatment Response in Multiple Sclerosis Patients.
Article in Diseases (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundImmunological monitoring in multiple sclerosis (MS) patients treated with disease-modifying drugs may help predict infectious complications and guide treatment. The main objective of this study was to evaluate whether anti-CD20 treatments in MS patients induce immunodeficiency and whether certain immunological parameters can predict the risk of infection and response to treatment.
methodsThis retrospective, observational, single-centre study included MS patients who started treatment with ocrelizumab or rituximab and received follow-up in the Neuroimmunology Unit of our centre between January 2017 and January 2023. The study was conducted in collaboration with the Immunology Department of this hospital.
resultsFifty-five patients were included, with a mean age of 47 years and a follow-up period of 24 months. Analyses of lymphocyte subpopulations (T, B, NK) and immunoglobulin levels (IgG, IgA, IgM) were performed before treatment and at 6-, 12- and 24-month follow-ups. In addition, we carried out an exhaustive study of B cells in the baseline analysis. Sixty-four percent of patients presented infections, mostly due to COVID-19. Three patients developed cryptogenic organising pneumonia. IgG hypogammaglobulinemia was the main risk factor for developing infections. Patients with infections had fewer mature memory B cells and a lower percentage of NK cells. Furthermore, a lower proportion of naïve and mature memory B cells was associated with inflammatory activity and disease progression, respectively. The absence of CD20 depletion during follow-up was associated with clinical worsening.
conclusionsBaseline immunophenotype and immunological monitoring can help predict the risk of infections and the efficacy of anti-CD20 therapy in MS patients.
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