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May 15, 2026Journal of Neurology0 citationsOpen Access

Ocrelizumab in early relapsing–remitting multiple sclerosis: first interim analysis of the MUSPO Italian prospective cohort

MFMassimo FilippiEDEmanuele D’AmicoVMVincenzo Brescia Morra

Key Points

  • To assess the baseline demographic, clinical, radiological, and treatment characteristics of the MUSPO cohort in early relapsing multiple sclerosis patients.
  • Prospective, multicenter, observational study with enrollment from September 2023 to May 2025.
  • Included 199 early relapsing-remitting MS patients, with baseline MRI assessments.
  • Used descriptive statistics to summarize demographic and clinical data.
  • Of 208 enrolled patients, 199 were eligible, showing a median Expanded Disability Status Scale score of 2.0, indicating mild disability.
  • Prior disease-modifying therapy exposure was noted in 29.6% of patients, with a median time of 1.4 months from last DMT to ocrelizumab.
  • MRI at diagnosis was available for 94.5% of patients, with gadolinium contrast used in 83.5% of MRI scans.

Abstract

BACKGROUND: Real-world evidence on ocrelizumab in early, minimally pretreated relapsing multiple sclerosis (MS) patients remains limited. OBJECTIVE: To describe baseline demographic, clinical, radiological, and treatment characteristics of the MUSPO cohort. METHODS: MUSPO is a prospective, multicenter, observational study. Enrollment occurred from September 2023 to May 2025. Adults with relapsing-remitting MS (RRMS), including a rapidly evolving severe RRMS (RES) group, were enrolled ~ 6 months after starting ocrelizumab. MRI was acquired according to clinical practice with centralized reading. NEDA-plus (absence of relapses, disability worsening, MRI activity, brain atrophy, and cognitive worsening) will be assessed at years 1-4. Baseline descriptive statistics were used. RESULTS: Of 208 patients enrolled across 31 Italian sites, 199 were eligible (RRMS N = 59; RES N = 140) for the interim analysis. Median Expanded Disability Status Scale was 2.0 (IQR 1.0-3.0), indicating mild disability. Prior disease-modifying therapy (DMT) exposure occurred in 59/199 patients (29.6%); time from last DMT to ocrelizumab was a median 1.4 months (IQR 0.7-2.0). MRI at diagnosis was available for 188/199 patients (94.5%), gadolinium used in 157/188 scans (83.5%). Baseline MRI was available for all patients with gadolinium administered in 166/199 cases (83.4%). Cognitive assessment using the Symbol Digit Modalities Test was completed by 150/199 (75.4%) of patients. CONCLUSIONS: The MUSPO study captures a predominantly young, mildly disabled, early-treated cohort, some of whom have prior DMT exposure. Together with comprehensive baseline MRI and limited prior DMT use, these features provide a robust foundation to evaluate NEDA-plus and other longitudinal effectiveness endpoints in Italian practice.

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Cite This Study

Filippi et al. (2026) studied this question.

synapsesocial.com/papers/6a06b940e7dec685947abd82https://doi.org/10.1007/s00415-026-13830-0
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