{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T05:47:49Z","timestamp":1792043269341,"version":"4.4.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neurol Belg"],"DOI":"10.1007\/s13760-026-03207-5","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T05:15:32Z","timestamp":1792041332000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative effectiveness and safety of rituximab versus ocrelizumab in relapsing\u2013remitting multiple sclerosis: a real-world experience from Iran"],"prefix":"10.1007","author":[{"given":"Fatemeh","family":"Meshkini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahid Beladi","family":"Moghaddam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehran","family":"Ghaffari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elham Asl","family":"Fallah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7168-9069","authenticated-orcid":false,"given":"Sepideh","family":"Paybast","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"issue":"4","key":"3207_CR1","doi-asserted-by":"publisher","first-page":"375","DOI":"10.5603\/pjnns.103955","volume":"59","author":"K Kapica-Topczewska","year":"2025","unstructured":"Kapica-Topczewska K, Ku\u0142akowska A, Kochanowicz J, Brola W (2025) Epidemiology of multiple sclerosis: global trends, regional differences, and clinical implications. Neurol Neurochir Pol 59(4):375\u2013384. https:\/\/doi.org\/10.5603\/pjnns.103955","journal-title":"Neurol Neurochir Pol"},{"issue":"7","key":"3207_CR2","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1007\/s11940-021-00677-1","volume":"23","author":"A Simpson","year":"2021","unstructured":"Simpson A, Mowry EM, Newsome SD (2021) Early Aggressive Treatment Approaches for Multiple Sclerosis. Curr Treat Options Neurol 23(7):19. https:\/\/doi.org\/10.1007\/s11940-021-00677-1","journal-title":"Curr Treat Options Neurol"},{"issue":"9","key":"3207_CR3","doi-asserted-by":"publisher","first-page":"5479","DOI":"10.1007\/s10072-022-06197-3","volume":"43","author":"K \u015aladowska","year":"2022","unstructured":"\u015aladowska K, Kawalec P, Holko P, Osiecka O (2022) Comparative safety of high-efficacy disease-modifying therapies in relapsing\u2013remitting multiple sclerosis: a systematic review and network meta-analysis. Neurol Sci 43(9):5479\u20135500. https:\/\/doi.org\/10.1007\/s10072-022-06197-3","journal-title":"Neurol Sci"},{"issue":"10","key":"3207_CR4","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1016\/j.neurol.2023.12.013","volume":"180","author":"SA Freeman","year":"2024","unstructured":"Freeman SA, Z\u00e9phir H (2024) Anti-CD20 monoclonal antibodies in multiple sclerosis: Rethinking the current treatment strategy. Rev Neurol (Paris) 180(10):1047\u20131058. https:\/\/doi.org\/10.1016\/j.neurol.2023.12.013","journal-title":"Rev Neurol (Paris)"},{"issue":"8","key":"3207_CR5","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1016\/S1474-4422(22)00209-5","volume":"21","author":"A Svenningsson","year":"2022","unstructured":"Svenningsson A, Frisell T, Burman J, Salzer J, Fink K, Hallberg S et al (2022) Safety and efficacy of rituximab versus dimethyl fumarate in patients with relapsing-remitting multiple sclerosis or clinically isolated syndrome in Sweden: a rater-blinded, phase 3, randomised controlled trial. Lancet Neurol 21(8):693\u2013703. https:\/\/doi.org\/10.1016\/S1474-4422(22)00209-5","journal-title":"Lancet Neurol"},{"issue":"3","key":"3207_CR6","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1001\/jamaneurol.2017.4011","volume":"75","author":"M Granqvist","year":"2018","unstructured":"Granqvist M, Boremalm M, Poorghobad A, Svenningsson A, Salzer J, Frisell T et al (2018) Comparative Effectiveness of Rituximab and Other Initial Treatment Choices for Multiple Sclerosis. JAMA Neurol 75(3):320. https:\/\/doi.org\/10.1001\/jamaneurol.2017.4011","journal-title":"JAMA Neurol"},{"issue":"3","key":"3207_CR7","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1056\/NEJMoa1601277","volume":"376","author":"SL Hauser","year":"2017","unstructured":"Hauser SL, Bar-Or A, Comi G, Giovannoni G, Hartung HP, Hemmer B et al (2017) Ocrelizumab versus Interferon Beta-1a in Relapsing Multiple Sclerosis. N Engl J Med 376(3):221\u2013234. https:\/\/doi.org\/10.1056\/NEJMoa1601277","journal-title":"N Engl J Med"},{"key":"3207_CR8","unstructured":"World Health Organization WHO endorses landmark public health decisions on Essential Medicines for Multiple Sclerosis"},{"key":"3207_CR9","doi-asserted-by":"publisher","first-page":"105435","DOI":"10.1016\/j.msard.2024.105435","volume":"83","author":"B Yamout","year":"2024","unstructured":"Yamout B, Al-Jumah M, Sahraian MA, Almalik Y, Khaburi J, Al, Shalaby N et al (2024) Consensus recommendations for diagnosis and treatment of Multiple Sclerosis: 2023 revision of the MENACTRIMS guidelines. Mult Scler Relat Disord 83:105435. https:\/\/doi.org\/10.1016\/j.msard.2024.105435","journal-title":"Mult Scler Relat Disord"},{"issue":"8","key":"3207_CR10","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1001\/jamaneurol.2023.1625","volume":"80","author":"I Roos","year":"2023","unstructured":"Roos I, Hughes S, McDonnell G, Malpas CB, Sharmin S, Boz C et al (2023) Rituximab vs Ocrelizumab in Relapsing-Remitting Multiple Sclerosis. JAMA Neurol 80(8):789. https:\/\/doi.org\/10.1001\/jamaneurol.2023.1625","journal-title":"JAMA Neurol"},{"issue":"7","key":"3207_CR11","doi-asserted-by":"publisher","first-page":"3676","DOI":"10.1007\/s00415-022-10989-0","volume":"269","author":"C Alcal\u00e1","year":"2022","unstructured":"Alcal\u00e1 C, Quintanilla-Bord\u00e1s C, Gasc\u00f3n F, Sempere \u00c1P, Navarro L, Carcel\u00e9n-Gadea M et al (2022) Effectiveness of rituximab vs. ocrelizumab for the treatment of primary progressive multiple sclerosis: a real-world observational study. J Neurol 269(7):3676\u20133681. https:\/\/doi.org\/10.1007\/s00415-022-10989-0","journal-title":"J Neurol"},{"issue":"6","key":"3207_CR12","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1097\/MOP.0000000000001396","volume":"36","author":"D DiGiacomo","year":"2024","unstructured":"DiGiacomo D, Barmettler S (2024) Secondary hypogammaglobulinemia: diagnosis and management of a pediatric condition of clinical importance. Curr Opin Pediatr 36(6):659\u2013667. https:\/\/doi.org\/10.1097\/MOP.0000000000001396","journal-title":"Curr Opin Pediatr"},{"key":"3207_CR13","doi-asserted-by":"publisher","first-page":"102787","DOI":"10.1016\/j.msard.2021.102787","volume":"49","author":"KR Cotchett","year":"2021","unstructured":"Cotchett KR, Dittel BN, Obeidat AZ (2021) Comparison of the Efficacy and Safety of Anti-CD20 B Cells Depleting Drugs in Multiple Sclerosis. Mult Scler Relat Disord 49:102787. https:\/\/doi.org\/10.1016\/j.msard.2021.102787","journal-title":"Mult Scler Relat Disord"},{"issue":"9","key":"3207_CR14","doi-asserted-by":"publisher","first-page":"1157","DOI":"10.1177\/1352458518757930","volume":"24","author":"F Piehl","year":"2018","unstructured":"Piehl F, Hillert J (2018) Rituximab is an acceptable alternative to ocrelizumab for treating multiple sclerosis \u2013 Yes. Multiple Scler J 24(9):1157\u20131159. https:\/\/doi.org\/10.1177\/1352458518757930","journal-title":"Multiple Scler J"},{"issue":"9","key":"3207_CR15","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1177\/1352458518757931","volume":"24","author":"MT Wallin","year":"2018","unstructured":"Wallin MT (2018) Rituximab is an acceptable alternative to ocrelizumab for treating multiple sclerosis \u2013 No. Multiple Scler J 24(9):1159\u20131161. https:\/\/doi.org\/10.1177\/1352458518757931","journal-title":"Multiple Scler J"},{"key":"3207_CR16","doi-asserted-by":"publisher","unstructured":"Hartung DM (2021) Health economics of disease-modifying therapy for multiple sclerosis in the United States. Ther Adv Neurol Disord 14. https:\/\/doi.org\/10.1177\/1756286420987031","DOI":"10.1177\/1756286420987031"},{"key":"3207_CR17","doi-asserted-by":"publisher","unstructured":"Evertsson B, Hoyt T, Christensen A, Nimer FAL, Foley J, Piehl F (2020) A comparative study of tolerability and effects on immunoglobulin levels and CD19 cell counts with ocrelizumab vs low dose of rituximab in multiple sclerosis. Mult Scler J Exp Transl Clin 6(4). https:\/\/doi.org\/10.1177\/2055217320964505","DOI":"10.1177\/2055217320964505"},{"key":"3207_CR18","doi-asserted-by":"publisher","unstructured":"Elgenidy A, Abdelhalim NN, Al-kurdi MA, mahdi, Mohamed LA, Ghoneim MM, Fathy AW et al (2024) Hypogammaglobulinemia and infections in patients with multiple sclerosis treated with anti-CD20 treatments: a systematic review and meta-analysis of 19,139 multiple sclerosis patients. Front Neurol 15. https:\/\/doi.org\/10.3389\/fneur.2024.1380654","DOI":"10.3389\/fneur.2024.1380654"},{"key":"3207_CR19","doi-asserted-by":"publisher","unstructured":"Fernandes AA, Neves AL, Ferro D, Seabra M, Mendon\u00e7a T, dos Reis RS et al (2025) Clinical and analytical monitoring of patients with multiple sclerosis on anti-CD20 therapeutics: a real-world safety profile study. Front Neurol 15. https:\/\/doi.org\/10.3389\/fneur.2024.1500763","DOI":"10.3389\/fneur.2024.1500763"},{"key":"3207_CR20","doi-asserted-by":"publisher","first-page":"578066","DOI":"10.1016\/j.jneuroim.2023.578066","volume":"377","author":"V Mears","year":"2023","unstructured":"Mears V, Jakubecz C, Seeco C, Woodson S, Serra A, Abboud H (2023) Predictors of hypogammaglobulinemia and serious infections among patients receiving ocrelizumab or rituximab for treatment of MS and NMOSD. J Neuroimmunol 377:578066. https:\/\/doi.org\/10.1016\/j.jneuroim.2023.578066","journal-title":"J Neuroimmunol"},{"key":"3207_CR21","doi-asserted-by":"publisher","first-page":"106191","DOI":"10.1016\/j.msard.2024.106191","volume":"93","author":"K Smolik","year":"2025","unstructured":"Smolik K, Camilli F, Panzera I, Fiore A, Franceschini A, Foschi M et al (2025) Hypogammaglobulinemia and severe infections in Multiple Sclerosis patients on anti-CD20 agents: A multicentre study. Mult Scler Relat Disord 93:106191. https:\/\/doi.org\/10.1016\/j.msard.2024.106191","journal-title":"Mult Scler Relat Disord"}],"container-title":["Acta Neurologica Belgica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13760-026-03207-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s13760-026-03207-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13760-026-03207-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T05:15:33Z","timestamp":1792041333000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s13760-026-03207-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,14]]},"references-count":21,"alternative-id":["3207"],"URL":"https:\/\/doi.org\/10.1007\/s13760-026-03207-5","relation":{},"ISSN":["0300-9009","2240-2993"],"issn-type":[{"value":"0300-9009","type":"print"},{"value":"2240-2993","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,14]]},"assertion":[{"value":"13 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no conflict of interest.","order":1,"name":"Ethics","label":"Competing interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"During the preparation of this work, the authors used QuillBot and ChatGPT 4o by OpenAI to improve paper readability. After using this service, the authors reviewed and edited the content as needed and took full responsibility for the publication\u2019s content.","order":2,"name":"Ethics","label":"Declaration of Generative AI and AI-assisted Technologies in the Writing process","group":{"name":"EthicsHeading","label":"Declarations"}}]}}