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Enrollment occurred from September 2023 to May 2025. Adults with relapsing\u2013remitting MS (RRMS), including a rapidly evolving severe RRMS (RES) group, were enrolled\u2009~\u20096\u00a0months 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\u20134. Baseline descriptive statistics were used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 208 patients enrolled across 31 Italian sites, 199 were eligible (RRMS N\u2009=\u200959; RES N\u2009=\u2009140) for the interim analysis. Median Expanded Disability Status Scale was 2.0 (IQR 1.0\u20133.0), 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\u00a0months (IQR 0.7\u20132.0). 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00415-026-13830-0","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T14:03:16Z","timestamp":1778680996000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ocrelizumab in early relapsing\u2013remitting multiple sclerosis: first interim analysis of the MUSPO Italian prospective 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Vincenzo Brescia Morra received grants to his institution (AOU Federico II) and honoraria from Novartis, Roche, Biogen, Teva, Almirall, Sanofi-Genzyme, Merck, Bayer, Mylan, and Bristol-Myers Squibb. Massimiliano Mirabella received speaking fees from Novartis, Roche, Sanofi-Genzyme, Janssen, Viatris, Alexion, and Amgen. Antonella Conte received honoraria for speaking or consultation fees from Almirall, Biogen Idec, Bristol-Myers Squibb, Merck Serono, Novartis, Sanofi-Genzyme, Roche, Alexion, and Neuraxpharma. Valentina Tomassini received consulting fees, honoraria or lecture fees, and support for attending meetings or travel from Roche, Novartis, Sanofi, Merck, Viatris, Almirall, Amgen, Alexion, Horizon, Bristol-Myers Squibb, Janssen, Biogen, Juvis\u00e8, and Lundbeck. Cinzia Masini, Valeria Perosino, and Paola Tortorella are employed by Roche SpA and may own stock or stock options. Maria Assunta Rocca received research grants from the MS Society of Canada, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla; consulting fees from Biogen, Bristol-Myers Squibb, and Roche; and speaker honoraria from Alexion, Biogen, Bristol-Myers Squibb, Celgene, Horizon Therapeutics Italy, Merck Serono SpA, Mitsubishi-Tanabe Pharma, Neuraxpharm, Novartis, Roche, Sandoz, and Sanofi; she is Associate Editor of Multiple Sclerosis and Related Disorders and Associate Co-Editor for Europe and Africa of Multiple Sclerosis Journal. Emanuele D\u2019Amico, Chiara Zanetta, Aurora Zangh\u00ec, Paola Sofia Di Filippo, Elena Longobardi, and Elena Colombo declare no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"This study was conducted in compliance with the Declaration of Helsinki, GCP standards, International Council for Harmonisation (ICH) guidelines, and national regulations. Ethics approval (protocol ID: ML44477) was granted on 31 May 2023 from the Territorial Ethics Committee \u2013 South West Veneto (Comitato Etico Territoriale Area Sud Ovest Veneto). All participants provided informed consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"302"}}