{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T07:01:13Z","timestamp":1785308473791,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe long\u2010term outcomes after anti\u2010CD20 discontinuation in selected patients with secondary progressive multiple sclerosis (SPMS) who remained without subsequent disease\u2010modifying therapy (DMT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed data from four centers in Austria and Switzerland. Inclusion criteria were SPMS, \u2265\u20092 anti\u2010CD20 cycles, discontinuation without subsequent DMT, and \u2265\u200936\u2009months follow\u2010up. The primary endpoint was time to first confirmed Expanded Disability Status Scale (EDSS) worsening, defined as a \u2265\u20090.5\u2010point increase after discontinuation documented at a subsequent routine visit. Secondary endpoints were relapses, MRI activity, and severe infections. No continuation cohort was available.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010five patients were included (61% female). Mean age at anti\u2010CD20 start was 53.5\u2009\u00b1\u20096.6\u2009years, disease duration 19.3\u2009\u00b1\u200910.1\u2009years, treatment duration 32.8\u2009\u00b1\u200916.1\u2009months, and post\u2010discontinuation follow\u2010up 55.1\u2009\u00b1\u200914.1\u2009months. Mean EDSS increased from 5.9\u2009\u00b1\u20091.3 before anti CD20, to 6.3\u2009\u00b1\u20091.3 at discontinuation and 6.9\u2009\u00b1\u20091.2 at last follow\u2010up. Confirmed EDSS worsening occurred in 31 patients (56%). Hazard analysis suggested an exploratory late increase between 48 and 60\u2009months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043) based on small numbers at risk. Relapses occurred in 6 patients (10.9%), MRI activity in 4\/35 (11%), and severe infections in 17 (31%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this selected SPMS cohort, focal inflammatory activity was uncommon, whereas confirmed EDSS worsening accumulated over long\u2010term follow\u2010up. Because inclusion required \u2265\u200936\u2009months untreated follow\u2010up, early disease activity may have been underestimated, and apparent stability may have been overestimated. Findings are descriptive and hypothesis\u2010generating and do not establish safety or optimal timing of anti\u2010CD20 discontinuation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70483","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:07:04Z","timestamp":1785305224000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Disease Course After Anti\u2010\n                    <scp>CD20<\/scp>\n                    Discontinuation in Secondary Progressive Multiple Sclerosis\u2014A Multicenter Long\u2010Term Longitudinal Study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1568-089X","authenticated-orcid":false,"given":"Ferdinand","family":"Otto","sequence":"first","affiliation":[{"name":"Department of Neurology Christian\u2010Doppler University Hospital, Paracelsus Medical University  Salzburg Austria"},{"name":"Department of Neurology University Hospital Z\u00fcrich and University of Zurich  Z\u00fcrich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dariia","family":"Kliushnikova","sequence":"additional","affiliation":[{"name":"Department of Neurology Christian\u2010Doppler University Hospital, Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5704-9097","authenticated-orcid":false,"given":"Richard Friedrich","family":"Radlberger","sequence":"additional","affiliation":[{"name":"Department of Neurology Christian\u2010Doppler University Hospital, Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinan","family":"Yasaroglu","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Z\u00fcrich and University of Zurich  Z\u00fcrich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5397-5595","authenticated-orcid":false,"given":"Tobias","family":"Moser","sequence":"additional","affiliation":[{"name":"Department of Neurology Christian\u2010Doppler University Hospital, Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Harrer","sequence":"additional","affiliation":[{"name":"Department of Neurology Christian\u2010Doppler University Hospital, Paracelsus Medical University  Salzburg Austria"},{"name":"Department of Dermatology and Allergology University Hospital, Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kitty","family":"Kratzer","sequence":"additional","affiliation":[{"name":"Department of Neurology Christian\u2010Doppler University Hospital, Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7696-1479","authenticated-orcid":false,"given":"Wolfgang","family":"Hitzl","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Optometry Paracelsus Medical University  Salzburg Austria"},{"name":"Research Program Experimental Ophthalmology &amp; Glaucoma Research Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Gradl","sequence":"additional","affiliation":[{"name":"Department of Neurology Medical University of St. P\u00f6lten  St. P\u00f6lten Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Schmidauer","sequence":"additional","affiliation":[{"name":"Department of Neurology Medical University of Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Roth","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Z\u00fcrich and University of Zurich  Z\u00fcrich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Hegen","sequence":"additional","affiliation":[{"name":"Department of Neurology Medical University of Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Wipfler","sequence":"additional","affiliation":[{"name":"Department of Neurology Christian\u2010Doppler University Hospital, Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"issue":"2","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1182\/blood.V83.2.435.435","article-title":"Depletion of B Cells In\u00a0Vivo by a Chimeric Mouse Human Monoclonal Antibody to CD20","volume":"83","author":"Reff M. 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