Evidence map›Paper›PMID 41558853›Full record

Observational studyJournal of neurology, neurosurgery, and psychiatry2026

Discontinuation of ocrelizumab in multiple sclerosis: reoccurrence of disease activity.

Franz Felix Konen, Franziska Axhausen, Stephanie Wolff, Pauline Mühlenbrock, Stefan Gingele, Konstantin Fritz Jendretzky, Sandra Nay, Lea Martha Grote-Levi, Philipp Schwenkenbecher, Sven G Meuth and 2 more

Abstract readObservational StudyMulticenter Study
In one paragraph

Observational study in Journal of neurology, neurosurgery, and psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
  4. Article
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

12 authors.

Franz Felix KonenDepartment of Neurology, Hannover Medical School, Hanover, Germany.ORCID http://orcid.org/0000-0002-8609-5674
Franziska AxhausenDepartment of Neurology, Justus-Liebig-University Giessen, Giessen, Germany.
Stephanie WolffDepartment of Neurology, Justus-Liebig-University Giessen, Giessen, Germany.
Pauline MühlenbrockDepartment of Neurology, Justus-Liebig-University Giessen, Giessen, Germany.
Stefan GingeleDepartment of Neurology, Hannover Medical School, Hanover, Germany.ORCID http://orcid.org/0000-0002-6055-5695
Konstantin Fritz JendretzkyDepartment of Neurology, Hannover Medical School, Hanover, Germany.ORCID http://orcid.org/0000-0002-2953-0166
Sandra NayDepartment of Neurology, Hannover Medical School, Hanover, Germany.
Lea Martha Grote-LeviDepartment of Neurology, Hannover Medical School, Hanover, Germany.
Philipp SchwenkenbecherDepartment of Neurology, Hannover Medical School, Hanover, Germany.
Sven G MeuthDepartment of Neurology, Heinrich-Heine-University Dusseldorf, Düsseldorf, Germany.
Thomas Skripuletz *Department of Neurology, Hannover Medical School, Hanover, Germany.ORCID http://orcid.org/0000-0001-8550-335X
Steffen Pfeuffer *Department of Neurology, Justus-Liebig-University Giessen, Giessen, Germany steffen.pfeuffer@neuro.med.uni-giessen.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe optimal strategy after discontinuation of B-cell depleting therapies like ocrelizumab in people with multiple sclerosis (pwMS) remains uncertain, particularly regarding delayed disease reactivation, disability progression and required treatment duration before cessation.

methodsIn this prospective two-centre observational cohort study with propensity score-matched (PSM) analysis, we evaluated recurrence of disease activity and disability worsening after ocrelizumab discontinuation. PwMS fulfilling the 2017 McDonald criteria were enrolled between January 2018 and December 2023 at two German MS centres. Participants received ocrelizumab for ≥12 months with no inflammatory activity in the preceding 12 months. Of 655 eligible patients (continuers, n=578; discontinuers, n=77), 290 were included after 4:1 PSM. The primary exposure was discontinuation, mainly due to infection concerns during COVID-19 (81%) or hypogammaglobulinaemia (16%). Main outcomes were time to combined inflammatory activity (CIA) and progression independent of relapse activity (PIRA). Receiver operating characteristic (ROC) identified optimal treatment duration.

resultsAfter median follow-up of 28.5 months, there was no significant difference in CIA risk between groups (HR: 0.91, 95% CI 0.08 to 10.79) or for PIRA (HR: 4.8, 95% CI 0.38 to 60.2). Beyond 24 months after discontinuation, disease activity remained stable, with a numerical rise that did not reach statistical significance. ROC analysis suggested no further reduction of activity beyond 29-30 months of therapy, but increasing reactivation risk after >32 months off-treatment.

conclusionsFor stable pwMS, ocrelizumab discontinuation after about 30 months on-treatment appears safe short-term, though vigilant monitoring is warranted beyond 2 years off-treatment due to potential delayed reactivation.

Indexed as

Antibodies, Monoclonal, HumanizedImmunologic FactorsMultiple SclerosisAdultDisease ProgressionFemaleHumansMaleMiddle AgedProspective StudiesRecurrenceTreatment InterruptionAntibodies, Monoclonal, HumanizedImmunologic FactorsocrelizumabIMMUNOTHERAPYMULTIPLE SCLEROSISNEUROIMMUNOLOGY

Identifiers

PMID41558853
PMCPMC13217088

What Socratic holds

Textmetadata
LicenceCC BY-NC
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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 Socratic graph.