Multiple sclerosis and related disorders最新文献

{"title":"Brain Age","authors":"Rodney Lea , Stasson Lea , Gavin Giovannoni , Chris Hawkes , Michael Levy , E. Ann Yeh , Jeannette Lechner-Scott","doi":"10.1016/j.msard.2025.106891","DOIUrl":"10.1016/j.msard.2025.106891","url":null,"abstract":"","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"104 ","pages":"Article 106891"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145732895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significance and stability of cerebrospinal fluid oligoclonal band patterns in multiple sclerosis","authors":"V Swane ,&nbsp;M Magyari ,&nbsp;H Højsgaard Chow ,&nbsp;PEH Jensen ,&nbsp;PS Sørensen ,&nbsp;HB Søndergaard ,&nbsp;F Sellebjerg","doi":"10.1016/j.msard.2025.106893","DOIUrl":"10.1016/j.msard.2025.106893","url":null,"abstract":"<div><h3>Background</h3><div>Immunoglobulin G (IgG) oligoclonal bands (OCBs) in cerebrospinal fluid (CSF) is included in the diagnostic criteria for multiple sclerosis (MS), but their temporal stability and clinical significance remain uncertain. These issues were addressed in a retrospective cohort study.</div></div><div><h3>Methods</h3><div>Patients analyzed for OCBs at a central laboratory were included (<em>n</em> = 16,596). Results and associations between OCBs, age at onset, and disease severity (assessed with the Age-Related Multiple Sclerosis Severity (ARMSS) score and Multiple Sclerosis Severity Score (MSSS)) were assessed.</div></div><div><h3>Results</h3><div>OCBs were more common in MS (91 %) than in CIS (71 %) and other diseases (10 %) (both <em>p</em> &lt; 0.001) and more frequent in CIS than other diseases (<em>p</em> &lt; 0.001). A single band pattern was more common in CIS (5.8 %) and other diseases (5.6 %) than in MS (2.0 %) (both <em>p</em> &lt; 0.001). In MS and CIS patients with repeated lumbar punctures, changes in OCBs occurred in 29 of 227 patients with MS (13 %) and 5 of 10 patients (50 %) with CIS (<em>p</em> = 0.007); 42 % changed from negative or single band to positive and 59 % from positive to negative or single band. MS patients with OCBs had 3.8 years earlier onset of disease (95 % confidence interval 2.2–5.4) but showed no difference in ARMSS or MSSS.</div></div><div><h3>Conclusion</h3><div>IgG OCBs were highly prevalent in MS and CIS; a single band pattern was more prevalent in CIS and other diseases than in MS. Changes in IgG OCB result were uncommon, particularly in MS. The presence of IgG OCBs is associated with lower age of onset but not with severity of MS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"106 ","pages":"Article 106893"},"PeriodicalIF":2.9,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transverse myelitis following COVID-19 infection or vaccination: Clinical outcomes and imaging characteristics compared with idiopathic cases","authors":"Ji-Yon Kim,&nbsp;Hee-Jae Jung,&nbsp;Shina Kim,&nbsp;Eun-Jae Lee,&nbsp;Hyunjin Kim,&nbsp;Young-Min Lim","doi":"10.1016/j.msard.2025.106892","DOIUrl":"10.1016/j.msard.2025.106892","url":null,"abstract":"<div><h3>Background</h3><div>The coronavirus disease 2019 (COVID-19) pandemic has revealed various neurological complications, including myelitis. This study examined the clinical and radiological characteristics of transverse myelitis occurring after COVID-19 infection or vaccination.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed medical records of patients diagnosed with transverse myelitis between January 2020 and March 2023. Patients were categorized into post-COVID-19 infection transverse myelitis (PITM), post-COVID-19 vaccination transverse myelitis (PVTM), or idiopathic transverse myelitis (ITM). Clinical and radiological characteristics were compared among groups.</div></div><div><h3>Results</h3><div>Patients with PITM had more severe deficits, presenting with a higher median modified Rankin Scale (mRS) score at hospitalization (5.0) than PVTM (3.0, <em>p</em> = 0.003) and ITM (2.0, <em>p</em> = 0.001). At six months, good functional outcomes (mRS ≤1) were least frequent in PITM (23.1 %) compared with PVTM (50.0 %) and ITM (73.9 %, <em>p</em> = 0.013). PITM showed more extensive spinal cord lesions (median: 14.0 segments) than PVTM (4.0, <em>p</em> = 0.029) and ITM (2.0, <em>p</em> = 0.001), and more multifocal axial lesions (75.0 %, <em>p</em> &lt; 0.001). Bilateral corticospinal tract involvement extending to the internal capsule was observed only in PITM (<em>n</em> = 3). MRI-negative myelitis was identified in one PITM and one PVTM case. Treatment escalation to IVIG, plasmapheresis, or immunosuppressants was more frequently required in PITM (69.2 %) than in PVTM (25.0 %) or ITM (8.7 %, <em>p</em> = 0.001).</div></div><div><h3>Conclusions</h3><div>PITM is associated with more severe deficits, extensive spinal cord involvement, and poorer outcomes than PVTM and ITM. Features such as bilateral corticospinal tract lesions and MRI-negative presentations may help distinguish COVID-19-related myelitis subtypes. Early recognition and timely escalation of immunotherapy are essential for improving outcomes in COVID-19-related myelitis.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"105 ","pages":"Article 106892"},"PeriodicalIF":2.9,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of COVID-19 on medical care and health service access in persons with multiple sclerosis – a cross-sectional study from the Australian MS Longitudinal Study","authors":"Jocelyn Tan ,&nbsp;Claudia H Marck ,&nbsp;Brook Galna ,&nbsp;Laura L Laslett ,&nbsp;Ingrid van der Mei ,&nbsp;Yvonne C Learmonth","doi":"10.1016/j.msard.2025.106877","DOIUrl":"10.1016/j.msard.2025.106877","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to determine the self-reported impacts of COVID-19 on healthcare disruption for persons with multiple sclerosis (MS) in Australia and the personal characteristics and service factors associated with disruption.</div></div><div><h3>Methods</h3><div>We used 2020 data from the Australian MS Longitudinal Study survey. We used univariate and backward-stepwise regression to explore the disease-related and demographic predictors of: i) the self-perceived influence of COVID-19 on medical care; and ii) the impact of reduced access to health services on health. We also quantified the cumulative impact reduced access to each health service had on the cohort, incorporating the volume and severity of the impact on health.</div></div><div><h3>Results</h3><div>Of the 1484 participants who provided data, 548 (36.9 %) participants reported the pandemic influenced their medical care. Participants who reported the pandemic influenced their medical care had a younger age, more comorbidities and more disability. 454 (30.6 %) participants reported that reduced access to health services impacted their health. Reduced access was most commonly reported for general practice (311, 21 %), neurology (246, 16.6 %) and physiotherapy (214, 14.4 %). Reduced access to physiotherapy had the greatest cumulative impact on health. The cumulative personal impact of reduced access across all health services was associated with several factors, including younger age, female sex and disability.</div></div><div><h3>Conclusions</h3><div>One-third of Australians with MS experienced healthcare disruptions during the first year of the COVID-19 pandemic, with the reduced access to physiotherapy most significantly impacting health. The study underscores the importance of continuity of healthcare services during future crises and underscores the need for robust strategies such as hybrid healthcare models and telehealth frameworks to guard against risks to service delivery in the future.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"105 ","pages":"Article 106877"},"PeriodicalIF":2.9,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebrovascular hemodynamics and cardiac biomarkers in multiple sclerosis: A case–control study","authors":"Iria López-Dequidt ,&nbsp;Eugenia Fernández-Mellid ,&nbsp;Eva Costa-Arpín ,&nbsp;Amparo Martínez-Monzonís ,&nbsp;María Santamaría-Cadavid ,&nbsp;Susana Arias-Rivas ,&nbsp;Manuel Rodríguez-Yáñez ,&nbsp;Iago García-Díaz ,&nbsp;Esperanza Ortegón-Aguilar ,&nbsp;José María Prieto-González","doi":"10.1016/j.msard.2025.106890","DOIUrl":"10.1016/j.msard.2025.106890","url":null,"abstract":"<div><h3>Introduction</h3><div>Cerebral blood flow is reduced in multiple sclerosis (MS), potentially due to a partially understood vascular component. Individuals with MS also have a higher cardiovascular disease burden than the general population. We aimed to characterize and compare subclinical vascular disease and thrombophilia in individuals with MS versus healthy controls.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, 60 individuals with MS and 60 age-and sex-matched controls underwent clinical evaluation, carotid and transcranial Doppler ultrasound, brachial artery flow-mediated dilation (FMD), and transthoracic echocardiography (TTE) and laboratory testing, including N-terminal pro–B-type natriuretic peptide (NT-proBNP) measurement. Thrombophilia was assessed via laboratory testing for acquired coagulation disorders. Associations of vascular (ICA and MCA PI, RI, CIMT, FMD) and cardiac (NT-proBNP, LVEF) parameters with Expanded Disability Status Scale (EDSS), MS subtype, and disease duration were examined using correlation and regression analyses adjusted for age, sex, and vascular risk factors.</div></div><div><h3>Results</h3><div>Individuals with MS showed significantly higher internal carotid artery pulsatility index (ICA PI ≥1.0; OR = 5.66, 95% CI 2.21-14.47, p &lt; 0.001). No significant differences were observed in carotid atherosclerosis, endothelial function, or thrombophilia between groups. NT-proBNP levels were markedly higher in secondary progressive MS (SPMS) compared with relapsing–remitting MS (RRMS) (median [p25–p75]: 322 [188-396] vs. 49.5 [24.8-80.0] pg/mL, p = 0.025). No associations were found between vascular or cardiac parameters and disease duration and EDSS.</div></div><div><h3>Conclusions</h3><div>Individuals with MS exhibit higher ICA PI compared with healthy controls, suggesting subtle subclinical alterations in cerebrovascular hemodynamics independent of traditional vascular risk factors or treatment status. Elevated NT-proBNP in SPMS may indicate mild cardiac strain associated with advanced disease stages. While these findings support the presence of vascular and cardiac involvement in MS, longitudinal studies are warranted to clarify causality and their potential role as biomarkers of disease progression.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"105 ","pages":"Article 106890"},"PeriodicalIF":2.9,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145668495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of autologous stem cell transplantation in patients with multiple sclerosis: A United Arab Emirates experience","authors":"Ruqqia Mir ,&nbsp;Fatima Al-Kaabi ,&nbsp;Lev Brylev ,&nbsp;Mohammed Abu-Haleeqa ,&nbsp;David Dennison ,&nbsp;Rupert Handgretinger ,&nbsp;Richard Burt ,&nbsp;Antonio Alfonso Bencomo-Hernandez ,&nbsp;Maysoon AlKaram ,&nbsp;Yendry Ventura-Carmenate ,&nbsp;Yandy Marx Castillo-Aleman ,&nbsp;Yara Afifi ,&nbsp;Ruaa Ballal Mousa Ali ,&nbsp;Sheima Ali ,&nbsp;Aseel Muhieddin ,&nbsp;Nameer Al-Saadawi ,&nbsp;Inas El-Najjar","doi":"10.1016/j.msard.2025.106889","DOIUrl":"10.1016/j.msard.2025.106889","url":null,"abstract":"<div><h3>Background</h3><div>Autologous hematopoietic stem-cell transplantation (AHSCT) is used for highly active, treatment-refractory multiple sclerosis (MS), but outcomes from the United Arab Emirates (UAE) are unreported. We evaluated safety, feasibility, and early effects on disability and inflammatory activity.</div></div><div><h3>Methods</h3><div>Single-center retrospective series at Yas Clinic Khalifa City, Abu Dhabi (Jan 2022–Jan 2025). Adults (18–60) with EDSS ≥3.0 and persistent inflammatory activity despite high-efficacy DMT or active SPMS underwent mobilization with cyclophosphamide+G-CSF, conditioning with high-dose cyclophosphamide+ATG, and reinfusion of ≥2 × 10^6 CD34⁺ cells/kg. Primary outcome: EDSS change at 3, 6, and 12 months; secondary outcomes: clinical relapses through 12 months and MRI activity at follow-up.</div></div><div><h3>Results</h3><div>Ten patients (7 women; mean age 28.9 years) were treated. Mean CD34⁺ dose was 7.43 × 10^6 cells/kg. Neutrophil engraftment occurred at a median of 9.5 days; 8/10 had transient CMV/EBV reactivation; no treatment-related mortality occurred. Median EDSS was 5.5 at baseline, 5.5 at 3 months, 5.5 at 6 months, and 4.5 among five patients at 12 months. EDSS improved in 1/10 at 3 months, 2/10 at 6 months, and 3/5 at 12 months; the remainder were stable and no patient worsened during available follow-up. Median relapses were 0 in the first 6 and 12 months; no new gadolinium-enhancing lesions were detected at any follow-up visit.</div></div><div><h3>Conclusions</h3><div>In this first UAE experience, AHSCT was feasible and safe and produced early disability stabilization with progressive improvement among evaluable patients by 12 months, and complete suppression of focal inflammatory activity during follow-up. These data support integrating AHSCT into regional MS care while larger prospective studies define long-term benefit.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"105 ","pages":"Article 106889"},"PeriodicalIF":2.9,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145668578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypogammaglobulinemia and infection risks in multiple sclerosis patients receiving anti-CD20 monoclonal antibodies: Incidence, clinical implications, and longitudinal insights from a three-year Iranian cohort","authors":"Elham Asl Fallah ,&nbsp;Ali Emami ,&nbsp;Nahid Beladi Moghaddam ,&nbsp;Mehran Ghaffari ,&nbsp;Fatemeh Meshkini ,&nbsp;Sepideh Paybast","doi":"10.1016/j.msard.2025.106887","DOIUrl":"10.1016/j.msard.2025.106887","url":null,"abstract":"<div><h3>Introduction</h3><div>Anti-CD20 monoclonal antibodies are regarded as high efficacy disease-modifying therapy (DMT) for management of multiple sclerosis (MS). However, prolonged B-cell depletion might increase the risk of secondary hypogammaglobulinemia (SHG) and serious infections. Herein, we aimed to investigate the incidence, severity, and clinical correlates of SHG in MS patients receiving rituximab and ocrelizumab.</div></div><div><h3>Methods and materials</h3><div>Between January 2018 and February 2023, MS patients prescribed rituximab and ocrelizumab at Imam Hossein MS Center in Tehran, Iran, were identified. Clinician-reported data were retrospectively collected.</div></div><div><h3>Results</h3><div>254 patients were enrolled. The majority (73.2 %) were female with a mean age of 41.22 ± 9.79 and a mean disease duration of 9.79 ± 5.46 years. Mean IgG levels declined from 1108.6 ± 205.6 mg/dL at baseline to 880.7 ± 199.9 mg/dL after three years. Over a mean follow-up of 44.43 ± 15.95 months, 48 patients (18.9 %) developed SHG (IgG &lt; 700 mg/dL), mostly asymptomatic (70.80 %) and mild (85.4 %). SHG was independently associated with lower baseline IgG levels (OR = 0.99 per unit increase; <em>P</em> = 0.001) and a standard interval dosing (SID) regimen (OR = 0.027, 95 % CI: 0.001–1.013, <em>P</em> = 0.051) in subgroup rituximab-treated patients. Serious infections occurred in 7.1 % of patients and were predicted by lower year-one IgG levels (OR = 0.98 per unit increase; <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Our results revealed an 18.9 % incidence rate of SHG in MS patients treated with anti-rituximab and ocrelizumab, which was mainly asymptomatic and mild. We also demonstrated the lower baseline IgG levels and SID regimen as a risk factor to develop SHG. The incidence of SHG at year one was strongly associated with an increased risk of infection. Our findings underscore the IgG monitoring before and during anti-CD20 treatment, along with patient-tailored anti-CD20 regimens to mitigate the risk of SHG and infection.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"106 ","pages":"Article 106887"},"PeriodicalIF":2.9,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Six-year safety and efficacy outcomes with first-line ofatumumab in recently diagnosed treatment-naive patients with relapsing multiple sclerosis","authors":"Stephen L. Hauser ,&nbsp;Mark S. Freedman ,&nbsp;Jin Nakahara ,&nbsp;David Paling ,&nbsp;Jérôme de Seze ,&nbsp;Jun Li ,&nbsp;Anil Abeyewickreme ,&nbsp;Min Wu ,&nbsp;Roseanne Sullivan ,&nbsp;Gabriel Pardo ,&nbsp;Xavier Montalban ,&nbsp;Heinz Wiendl","doi":"10.1016/j.msard.2025.106886","DOIUrl":"10.1016/j.msard.2025.106886","url":null,"abstract":"<div><h3>Background</h3><div>We report ofatumumab’s longer-term safety and efficacy in recently diagnosed (≤3 years) treatment-naive (RDTN) people living with relapsing multiple sclerosis (plwRMS).</div></div><div><h3>Methods</h3><div>Safety analyses included RDTN participants receiving at least 1 ofatumumab dose in ASCLEPIOS I/II or other ALITHIOS feeder studies (APLIOS and APOLITOS). Efficacy analyses included participants randomised to ofatumumab in ASCLEPIOS I/II and treated continuously for up to 6 years. Efficacy outcomes include annualised relapse rate (ARR), MRI lesions, no evidence of disease activity-3 (NEDA-3), cognitive processing speed, and work status.</div></div><div><h3>Results</h3><div>The safety analysis included 409 RDTN plwRMS. Exposure-adjusted incidence rates of serious infections and malignancies did not increase to the cut-off date (25-Sep-2025) of 6 years. Over 6 years, mean IgG levels remained stable and IgG was above the lower limit of normal (LLN: 5.65 g/L) in 98.0% of participants at all assessments; mean IgM levels decreased but IgM remained above LLN (0.4 g/L) in 64.1% of participants at all assessments. Of 314 RDTN participants receiving ofatumumab in ASCLEPIOS I/II (efficacy analysis), 233 entered ALITHIOS, and at data cut-off 181 (77.7%, 181/233) were still receiving ofatumumab. ARR decreased from 0.112 (Year 1) to 0.030 (Year 6). An almost complete suppression of MRI lesions was observed up to Year 6. NEDA-3 at Year 6 was observed in 94.4% of participants. At 6 years, up to 70.6% of participants experienced clinically meaningful improvement in cognitive processing speed. Reduced work absenteeism versus baseline was observed.</div></div><div><h3>Conclusions</h3><div>Findings support ofatumumab’s highly favourable longer-term benefit-risk profile as first-line therapy for plwRMS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"105 ","pages":"Article 106886"},"PeriodicalIF":2.9,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Solar rays incidence on the prevalence of multiple sclerosis and its correlation with Brazil’s macroregions: A systematic review and metanalysis","authors":"Wellydo Kesllowd Marinho Escarião ,&nbsp;Luísa de Sousa Frazão ,&nbsp;Hélida Maravilha Dantas e Sousa Almeida ,&nbsp;Anne Emmanuelle Câmara Melo ,&nbsp;Rand Randall Martins ,&nbsp;Arnóbio Antônio da Silva-Junior ,&nbsp;Alianda Maira Cornélio","doi":"10.1016/j.msard.2025.106883","DOIUrl":"10.1016/j.msard.2025.106883","url":null,"abstract":"<div><div>Multiple sclerosis (MS) is a chronic neurodegenerative disease of inflammatory and demyelinating nature, whose global distribution presents marked heterogeneity. International studies indicate a higher prevalence of MS in regions with lower incidence of solar radiation, which has been associated with reduced synthesis of vitamin D. In Brazil, however, there are few studies correlating the prevalence of the disease with geographic and environmental variables. To assess the prevalence of multiple sclerosis in Brazilian macroregions and to verify possible correlations with latitude, longitude, and mean annual solar radiation levels. A systematic search was conducted in the PubMed, Scopus, Web of Science, LILACS and SciELO databases, using the descriptors \"multiple sclerosis\", \"prevalence\" and \"Brazil\". Observational studies that reported prevalence data in Brazilian regions were included. The information was quantitatively synthesized and submitted to correlation analysis and meta-analysis based on geographic coordinates and solar radiation data. Thirty-four studies were included, covering the five macroregions of the country. The prevalence of MS showed wide regional variation, with higher values in the South and Southeast regions. However, no statistically significant correlations were observed between the prevalence of MS and the geographic parameters analyzed, including solar incidence. The findings reveal that in Brazil there is no relationship between the latitudinal gradient and the prevalence of MS, suggesting the influence of sociocultural, genetic and environmental factors specific to the country. Thus, the need for more comprehensive epidemiological studies in areas that are still little investigated is evident.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"105 ","pages":"Article 106883"},"PeriodicalIF":2.9,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of rituximab in the treatment of multiple sclerosis: A multicenter, retrospective, observational study in morocco","authors":"Jawad Oumerzouk ,&nbsp;Jawad Hafidi ,&nbsp;Mohamed Abdellaoui ,&nbsp;Mohamed Chraa ,&nbsp;Ahmed Bourazza","doi":"10.1016/j.msard.2025.106882","DOIUrl":"10.1016/j.msard.2025.106882","url":null,"abstract":"<div><h3>Introduction</h3><div>The demonstration of the strong efficacy of selective B-cell-depleting therapies, such as anti-CD20 monoclonal antibodies in multiple sclerosis (MS), point out the key role of B cells in triggering MS disease activity.</div></div><div><h3>Objective</h3><div>To investigate the effectiveness and safety of rituximab (RTX) in MS.</div></div><div><h3>Materials and methods</h3><div>We report a retrospective observational study to describe the effectiveness of off-label Rituximab (RTX) in the treatment of a population of 93 Moroccan MS patients including 66 (71 %) relapsing-remitting multiple sclerosis (RRMS) and 27 (29 %) progressive forms of multiple sclerosis (PMS).</div></div><div><h3>Results</h3><div>Our study showed that the RTX treatment was associated with the mean ARR decreasing by 71.5 % (<em>p</em> &lt; 0.001) with respect to the previous year and the majority of relapses (62.5 %) occurred within 6 months of starting treatment. The mean EDSS score of the overall patient cohort fell from 4.9 to 4.1 (<em>p</em> = 0.039) after 1 year of treatment with RTX and remained stable in the second year of therapy. EDSS scores improved (CID) after 1 year of treatment with RTX by a score of 0.5–1.0 in 43 (46.2 %) patients and remained stable in the following two years of therapy. Moreover, there was no evidence of disease activity measured by NEDA-3 in 74.2 % of the total sample up to their last follow-up, i.e., 53 (80.3 % ) of RRMS patients and 17 (62.9) % of PMS patients, and there was also a reduction in the number of GEL from 2.3 to 0.2 (<em>p</em> &lt; 0.001). Finally, RTX was discontinued in 7 (7.5 %) patients (4 SPMS, 3 PPMS) and the confirmed worsening of disability (CWD) was the reason for withdrawal.</div></div><div><h3>Conclusion</h3><div>Off-label RTX treatment should be considered as a therapeutic option for RRMS and some PMS patients, given its efficacy and safety profile with faster onset of action, long duration of action and favorable cost-effectiveness profile.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"105 ","pages":"Article 106882"},"PeriodicalIF":2.9,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}