Anti‐ <scp>CD20</scp> Discontinuation Versus Continuation in People Aged Over 50 With Non‐Active Multiple Sclerosis

OBJECTIVE: To determine whether discontinuing anti-CD20 therapy in people with relapsing-onset MS aged over 50 is associated with an increased risk of relapse, inflammatory activity, confirmed disability accrual, and serious infection compared with continuing therapy. METHODS: This observational, multicenter, retrospective cohort study included 2283 patients from the French MS registry aged > 50, who had received at least two cycles of anti-CD20 and had experienced no relapses or MRI activity for at least one year prior to inclusion. Patients were classified as discontinuing or continuing therapy and 1:1 matched using a time-dependent propensity score. Outcomes were time to first relapse, inflammatory activity (relapse and/or MRI activity), confirmed disability accrual, and serious infection. RESULTS: Among 1900 patients continuing therapy and 383 discontinuing, 224 in each group were matched (mean age = 57.7 ± 5.9 years; mean EDSS = 5.4 ± 1.7; median follow-up after matching = 34.8 [21.6-50.4] months). There were no significant differences between groups in time to first relapse (HR = 0.6, 95% CI 0.3-1.3, p = 0.2), inflammatory activity (HR = 0.9, 95% CI 0.5-1.4, p = 0.6), confirmed disability accrual (HR = 1.2, 95% CI 0.9-1.7, p = 0.2), and serious infections (HR = 1.0, 95% CI 0.6-1.8, p = 0.9). INTERPRETATION: This retrospective study found no evidence of differences between stopping and continuing anti-CD20 therapy regarding relapse, inflammatory activity, disability accrual, or serious infections in older patients with long-standing non-active MS over a median 2.9-year follow-up.

Authors

Institutions

Publication Details

Journal
Annals of Clinical and Translational Neurology
Published
2026-08-13
DOI
https://doi.org/10.1002/acn3.70497
Primary Topic
Multiple Sclerosis Research Studies
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Anti‐ CD20 Discontinuation Versus Continuation in People Aged Over 50 With Non‐Active Multiple Sclerosis

Jonathan Ciron, Abdullatif Al Khedr, Fabien Rollot, Abir Wahab et al.
Annals of Clinical and Translational Neurology
Multiple Sclerosis Research Studies
article

Anti‐ CD20 Discontinuation Versus Continuation in People Aged Over 50 With Non‐Active Multiple Sclerosis

Jonathan Ciron, Abdullatif Al Khedr, Fabien Rollot, Abir Wahab, Aurélie Ruet, Romain Casey, Anne Kerbrat, Amélie Dos Santos, Christine Lebrun‐Frénay, Jennifer Aboab, Karolina Hankiewicz, Arnaud Kwiatkowski, Mariana Sarov Riviere, G. Defer, T. David, Ines Doghri, Caroline Papeix, Jean‐Philippe Camdessanché, Bertrand Bourre, Pierre Labauge, Corinne Pottier, OFSEP Investigators, Hélène Zephir, Eric Thouvenot, Gilles Edan, Sandra Vukusic, Emmanuelle Le Page, Nicolas Collongues, Solène Moulin, Jérôme De Seze, Olivier Casez, Guillaume Mathey, Jean Pelletier, Laure Michel, Eric Berger, Maia Tchikviladze, Eric Manchon, David Axel Laplaud, Anne Laure Dubessy, Alexia Moukhine, Laurent Magy
article en

Abstract

OBJECTIVE: To determine whether discontinuing anti-CD20 therapy in people with relapsing-onset MS aged over 50 is associated with an increased risk of relapse, inflammatory activity, confirmed disability accrual, and serious infection compared with continuing therapy. METHODS: This observational, multicenter, retrospective cohort study included 2283 patients from the French MS registry aged > 50, who had received at least two cycles of anti-CD20 and had experienced no relapses or MRI activity for at least one year prior to inclusion. Patients were classified as discontinuing or continuing therapy and 1:1 matched using a time-dependent propensity score. Outcomes were time to first relapse, inflammatory activity (relapse and/or MRI activity), confirmed disability accrual, and serious infection. RESULTS: Among 1900 patients continuing therapy and 383 discontinuing, 224 in each group were matched (mean age = 57.7 ± 5.9 years; mean EDSS = 5.4 ± 1.7; median follow-up after matching = 34.8 [21.6-50.4] months). There were no significant differences between groups in time to first relapse (HR = 0.6, 95% CI 0.3-1.3, p = 0.2), inflammatory activity (HR = 0.9, 95% CI 0.5-1.4, p = 0.6), confirmed disability accrual (HR = 1.2, 95% CI 0.9-1.7, p = 0.2), and serious infections (HR = 1.0, 95% CI 0.6-1.8, p = 0.9). INTERPRETATION: This retrospective study found no evidence of differences between stopping and continuing anti-CD20 therapy regarding relapse, inflammatory activity, disability accrual, or serious infections in older patients with long-standing non-active MS over a median 2.9-year follow-up.

Annals of Clinical and Translational Neurology
Université Claude Bernard Lyon 1 (FR), Centre National de la Recherche Scientifique (FR), Université de Bordeaux (FR), Inserm (FR), Université de Montpellier (FR), Université de Lille (FR), Multiple Sclerosis Foundation (US), Canadian Armed Forces (CA), Centre Hospitalier Universitaire de Grenoble (FR), Centre hospitalier national d'ophtalmologie des Quinze-Vingts (FR), Institut de Recherche en Informatique et Systèmes Aléatoires (FR), Centre Hospitalier Universitaire de Lille (FR), Centre Hospitalier Universitaire de Nice (FR), Centre Hospitalier Universitaire Henri-Mondor (FR), Centre Hospitalier Universitaire de Toulouse (FR), Sorbonne Université (FR), Centre Hospitalier Universitaire de Besançon (FR), Centre Hospitalier Universitaire de Montpellier (FR), Centre de Recherche en Neurosciences de Lyon (FR), Centre Hospitalier Universitaire de Tours (FR), Centre Hospitalier Universitaire Amiens-Picardie (FR), Assistance Publique – Hôpitaux de Paris (FR), Hôpital Bretonneau (FR), Centre Hospitalier Régional et Universitaire de Nancy (FR), Observatoire Français de la Sclérose en Plaques (FR), Centre Hospitalier Universitaire de Nîmes (FR), Hôpital Pierre Wertheimer (FR), Centre Hospitalier Universitaire de Reims (FR), Bordeaux Population Health (FR), Centre Hospitalier Universitaire de Poitiers (FR), Centre Hospitalier Universitaire de Caen Normandie (FR), Hôpital Nord (FR), Centre Hospitalier Universitaire de Limoges (FR), Pitié-Salpêtrière Hospital (FR), Fondation Ophtalmologique Adolphe de Rothschild (FR), Centre Hospitalier de Gonesse (FR), Centre Jean Bernard (FR), Neurocentre Magendie (FR), Fondation de Rothschild (FR), Centre d'Investigation Clinique de Nantes (FR), Hôpitaux Universitaires Henri-Mondor (FR), BP (France) (FR), Centre Hospitalier Universitaire de Martinique (MQ), Translational Innovation in Medicine and Complexity (FR), Groupe Hospitalier de l'Institut Catholique de Lille (FR), Institut de Neurosciences de la Timone (FR), Centre Hospitalier Saint-Denis (FR), Centre Hospitalier Universitaire de Rouen (FR), Centre Hospitalier Universitaire de Rennes (FR), Institut de Génomique Fonctionnelle (FR), Hôpital Foch (FR), Centre Hospitalier Universitaire de Saint-Étienne (FR), Hôpital Dupuytren (FR), Hôpital de la Timone (FR), Bicêtre Hospital (FR), Interdisciplinarité en Santé Publique Interventions et Instruments de mesure complexes – Région Est (FR), Université de Rennes (FR), Université de Rouen Normandie (FR), Université de Nîmes (FR), Université de Strasbourg (FR), Université Grenoble Alpes (FR), Université de Lorraine (FR), Université de Reims Champagne-Ardenne (FR), Nantes Université (FR), Université de Caen Normandie (FR)
Openalex Percentile: Top 10%
Multiple Sclerosis Research Studies
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.