{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:09:32Z","timestamp":1790140172684,"version":"4.0.1"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"vor","delay-in-days":39,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Neurol"],"DOI":"10.1186\/s12883-025-04519-4","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T06:53:44Z","timestamp":1763708024000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparative efficacy and safety of ocrelizumab in relapsing-remitting and primary progressive multiple sclerosis: A systematic review and meta-analysis"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8996-2474","authenticated-orcid":false,"given":"Adil","family":"Nawaz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0930-8000","authenticated-orcid":false,"given":"Arsalan","family":"Bakhtiyar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2326-6004","authenticated-orcid":false,"given":"Muhammad Ibrahim","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7183-1022","authenticated-orcid":false,"given":"Erum","family":"Siddiqui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0085-0777","authenticated-orcid":false,"given":"Elsa","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Abbas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9510-7615","authenticated-orcid":false,"given":"Muhammad","family":"Saad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1628-0370","authenticated-orcid":false,"given":"Muhammad","family":"Qasim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9250-7959","authenticated-orcid":false,"given":"Muhammad","family":"Taha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"issue":"12","key":"4519_CR1","doi-asserted-by":"publisher","first-page":"1380","DOI":"10.1016\/j.amjmed.2020.05.049","volume":"133","author":"SL Hauser","year":"2020","unstructured":"Hauser SL, Cree BAC. Treatment of multiple sclerosis: A review. Am J Med. 2020;133(12):1380\u2013e13901382.","journal-title":"Am J Med"},{"issue":"12 Suppl","key":"4519_CR2","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1586\/14737175.2013.865866","volume":"13","author":"A Ascherio","year":"2013","unstructured":"Ascherio A. Environmental factors in multiple sclerosis. Expert Rev Neurother. 2013;13(12 Suppl):3\u20139.","journal-title":"Expert Rev Neurother"},{"key":"4519_CR3","doi-asserted-by":"publisher","unstructured":"Stys PK, Tsutsui S, Gafson AR, et al. New views on the complex interplay between degeneration and autoimmunity in multiple sclerosis. Front Cell Neurosci. 2024;18\u20132024.\u00a0https:\/\/doi.org\/10.3389\/fncel.2024.1426231.","DOI":"10.3389\/fncel.2024.1426231"},{"issue":"8","key":"4519_CR4","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1001\/jama.2020.26858","volume":"325","author":"MP McGinley","year":"2021","unstructured":"McGinley MP, Goldschmidt CH, Rae-Grant AD. Diagnosis and treatment of multiple sclerosis: a review. JAMA. 2021;325(8):765\u201379.","journal-title":"JAMA"},{"issue":"4","key":"4519_CR5","doi-asserted-by":"publisher","first-page":"380","DOI":"10.7861\/clinmed.2020-0292","volume":"20","author":"H Ford","year":"2020","unstructured":"Ford H. Clinical presentation and diagnosis of multiple sclerosis. Clin Med. 2020;20(4):380\u20133.","journal-title":"Clin Med"},{"issue":"1","key":"4519_CR6","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1111\/ene.13819","volume":"26","author":"R Dobson","year":"2019","unstructured":"Dobson R, Giovannoni G. Multiple sclerosis \u2013 a review. Eur J Neurol. 2019;26(1):27\u201340.","journal-title":"Eur J Neurol"},{"issue":"10","key":"4519_CR7","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. Anti-CD20 monoclonal antibodies in multiple sclerosis: rethinking the current treatment strategy. Rev Neurol (Paris). 2024;180(10):1047\u201358.","journal-title":"Rev Neurol (Paris)"},{"issue":"4","key":"4519_CR8","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1007\/s13311-017-0557-4","volume":"14","author":"JM Gelfand","year":"2017","unstructured":"Gelfand JM, Cree BAC, Hauser SL. Ocrelizumab and other CD20(+) B-cell-depleting therapies in multiple sclerosis. Neurotherapeutics. 2017;14(4):835\u201341.","journal-title":"Neurotherapeutics"},{"issue":"1","key":"4519_CR9","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1002\/ana.25119","volume":"83","author":"AL Greenfield","year":"2018","unstructured":"Greenfield AL, Hauser SL. B-cell therapy for multiple sclerosis: entering an era. Ann Neurol. 2018;83(1):13\u201326.","journal-title":"Ann Neurol"},{"issue":"Suppl 1Suppl 1","key":"4519_CR10","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1111\/ene.12883","volume":"23","author":"\u00d8 Torkildsen","year":"2016","unstructured":"Torkildsen \u00d8, Myhr KM, B\u00f8 L. Disease-modifying treatments for multiple sclerosis - a review of approved medications. Eur J Neurol. 2016;23(Suppl 1Suppl 1):18\u201327.","journal-title":"Eur J Neurol"},{"issue":"3","key":"4519_CR11","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1007\/s40265-022-01672-9","volume":"82","author":"YN Lamb","year":"2022","unstructured":"Lamb YN, Ocrelizumab. A review in multiple sclerosis. Drugs. 2022;82(3):323\u201334.","journal-title":"Drugs"},{"key":"4519_CR12","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","volume":"372","author":"MJ Page","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.","journal-title":"BMJ"},{"key":"4519_CR13","doi-asserted-by":"publisher","first-page":"d5928","DOI":"10.1136\/bmj.d5928","volume":"343","author":"JP Higgins","year":"2011","unstructured":"Higgins JP, Altman DG, G\u00f8tzsche PC, et al. The Cochrane collaboration\u2019s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.","journal-title":"BMJ"},{"issue":"9","key":"4519_CR14","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1007\/s10654-010-9491-z","volume":"25","author":"A Stang","year":"2010","unstructured":"Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603\u20135.","journal-title":"Eur J Epidemiol"},{"issue":"5","key":"4519_CR15","doi-asserted-by":"publisher","first-page":"2149","DOI":"10.1007\/s00415-023-12179-y","volume":"271","author":"A Bajrami","year":"2024","unstructured":"Bajrami A, Tamanti A, Peloso A, et al. Ocrelizumab reduces cortical and deep grey matter loss compared to the S1P-receptor modulator in multiple sclerosis. J Neurol. 2024;271(5):2149\u201358.","journal-title":"J Neurol"},{"issue":"2","key":"4519_CR16","doi-asserted-by":"publisher","first-page":"1166","DOI":"10.1007\/s13311-021-01037-2","volume":"18","author":"A Zangh\u00ec","year":"2021","unstructured":"Zangh\u00ec A, Gallo A, Avolio C, et al. Exit strategies in Natalizumab-treated RRMS at high risk of progressive multifocal leukoencephalopathy: a multicentre comparison study. Neurotherapeutics. 2021;18(2):1166\u201374.","journal-title":"Neurotherapeutics"},{"issue":"7","key":"4519_CR17","doi-asserted-by":"publisher","first-page":"4495","DOI":"10.1007\/s00415-024-12360-x","volume":"271","author":"A Zangh\u00ec","year":"2024","unstructured":"Zangh\u00ec A, Borriello G, Bonavita S, et al. Ocrelizumab and ofatumumab comparison: an Italian real-world propensity score matched study. J Neurol. 2024;271(7):4495\u2013502.","journal-title":"J Neurol"},{"issue":"4","key":"4519_CR18","volume":"6","author":"B Evertsson","year":"2020","unstructured":"Evertsson B, Hoyt T, Christensen A, et al. 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. 2020;6(4):2055217320964505.","journal-title":"Mult Scler J"},{"issue":"7","key":"4519_CR19","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, et al. Effectiveness of rituximab vs. ocrelizumab for the treatment of primary progressive multiple sclerosis: a real-world observational study. J Neurol. 2022;269(7):3676\u201381.","journal-title":"J Neurol"},{"issue":"6","key":"4519_CR20","doi-asserted-by":"publisher","first-page":"2121","DOI":"10.1007\/s10072-023-06608-z","volume":"44","author":"C Boz","year":"2023","unstructured":"Boz C, Ozakbas S, Terzi M, et al. The comparative effectiveness of fingolimod, natalizumab, and ocrelizumab in relapsing-remitting multiple sclerosis. Neurol Sci. 2023;44(6):2121\u20139.","journal-title":"Neurol Sci"},{"issue":"12","key":"4519_CR21","first-page":"1330","volume":"93","author":"C Zhu","year":"2022","unstructured":"Zhu C, Zhou Z, Roos I, et al. Comparing switch to ocrelizumab, cladribine or natalizumab after Fingolimod treatment cessation in multiple sclerosis. J Neurol Neurosurg Psychiatry. 2022;93(12):1330\u20137.","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"7","key":"4519_CR22","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1001\/jamaneurol.2023.1542","volume":"80","author":"C Zhu","year":"2023","unstructured":"Zhu C, Kalincik T, Horakova D, et al. Comparison between dimethyl fumarate, fingolimod, and ocrelizumab after natalizumab cessation. JAMA Neurol. 2023;80(7):739\u201348.","journal-title":"JAMA Neurol"},{"key":"4519_CR23","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2024.105594","author":"E Signoriello","year":"2024","unstructured":"Signoriello E, Signori A, Lus G, et al. NEDA-3 achievement in early highly active relapsing remitting multiple sclerosis patients treated with Ocrelizumab or natalizumab. Mult Scler Relat Disord. 2024. https:\/\/doi.org\/10.1016\/j.msard.2024.105594.","journal-title":"Mult Scler Relat Disord"},{"issue":"1","key":"4519_CR24","volume":"8","author":"E Alvarez","year":"2022","unstructured":"Alvarez E, Nair KV, Sillau S, et al. Tolerability and safety of switching from rituximab to ocrelizumab: evaluating factors associated with infusion related reactions. Mult Scler J. 2022;8(1):20552173211069359.","journal-title":"Mult Scler J"},{"issue":"8","key":"4519_CR25","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, et al. Rituximab vs ocrelizumab in relapsing-remitting multiple sclerosis. JAMA Neurol. 2023;80(8):789\u201397.","journal-title":"JAMA Neurol"},{"key":"4519_CR26","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2024.106191","author":"K Smolik","year":"2025","unstructured":"Smolik K, Camilli F, Panzera I, et al. Hypogammaglobulinemia and severe infections in multiple sclerosis patients on anti-CD20 agents: a multicentre study. Mult Scler Relat Disord. 2025. https:\/\/doi.org\/10.1016\/j.msard.2024.106191.","journal-title":"Mult Scler Relat Disord"},{"key":"4519_CR27","doi-asserted-by":"publisher","DOI":"10.1177\/17562864221142924","volume":"15","author":"K Pape","year":"2022","unstructured":"Pape K, Rolfes L, Steffen F, et al. Comparative effectiveness of natalizumab versus ocrelizumab in multiple sclerosis: a real-world propensity score-matched study. Ther Adv Neurol Disord. 2022;15:17562864221142924.","journal-title":"Ther Adv Neurol Disord"},{"issue":"6","key":"4519_CR28","doi-asserted-by":"publisher","first-page":"3295","DOI":"10.1007\/s00415-021-10950-7","volume":"269","author":"K Bigaut","year":"2022","unstructured":"Bigaut K, Kremer L, Fabacher T, et al. Ocrelizumab versus fingolimod after natalizumab cessation in multiple sclerosis: an observational study. J Neurol. 2022;269(6):3295\u2013300.","journal-title":"J Neurol"},{"issue":"9805","key":"4519_CR29","doi-asserted-by":"publisher","first-page":"1779","DOI":"10.1016\/S0140-6736(11)61649-8","volume":"378","author":"L Kappos","year":"2011","unstructured":"Kappos L, Li D, Calabresi PA, et al. Ocrelizumab in relapsing-remitting multiple sclerosis: a phase 2, randomised, placebo-controlled, multicentre trial. Lancet. 2011;378(9805):1779\u201387.","journal-title":"Lancet"},{"key":"4519_CR30","unstructured":"Randomized A, Double-Dummy D-B. Parallel-Group Study To Evaluate the Efficacy and Safety of Ocrelizumab in Comparison to Interferon Beta-1a (Rebif\u00ae) in Patients With Relapsing Multiple Sclerosis, NCT01247324.\u00a0https:\/\/clinicaltrials.gov\/study\/NCT01247324. Cgi."},{"key":"4519_CR31","unstructured":"Randomized A, Double-Dummy D-B. Parallel-Group study to evaluate the efficacy and safety of Ocrelizumab in comparison to interferon Beta-1a (Rebif) in patients with relapsing multiple Sclerosis. ClinicalTrials.gov ID: NCT01412333.\u00a0https:\/\/clinicaltrials.gov\/study\/NCT01412333."},{"key":"4519_CR32","unstructured":"Phase A III, Randomized M. Parallel-group, Double-blind, placebo controlled study to evaluate the efficacy and safety of Ocrelizumab in adults with primary progressive multiple Sclerosis. ClinicalTrials.gov ID: NCT\u00a001194570. https:\/\/clinicaltrials.gov\/study\/NCT01194570."},{"issue":"8","key":"4519_CR33","doi-asserted-by":"publisher","first-page":"2008","DOI":"10.1002\/acn3.52118","volume":"11","author":"P Iaffaldano","year":"2024","unstructured":"Iaffaldano P, Lucisano G, Guerra T, et al. A comparison of natalizumab and ocrelizumab on disease progression in multiple sclerosis. Ann Clin Transl Neurol. 2024;11(8):2008\u201315.","journal-title":"Ann Clin Transl Neurol"},{"key":"4519_CR34","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1086028","volume":"14","author":"P Santiago-Setien","year":"2023","unstructured":"Santiago-Setien P, Barqu\u00edn-Rego C, Hern\u00e1ndez-Mart\u00ednez P, et al. Switch to ocrelizumab in MS patients treated with natalizumab in extended interval dosing at high risk of PML: a 96-week follow-up pilot study. Front Immunol. 2023;14:1086028.","journal-title":"Front Immunol"},{"issue":"3","key":"4519_CR35","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1002\/ana.27143","volume":"97","author":"SG Meuth","year":"2025","unstructured":"Meuth SG, Wolff S, M\u00fcck A, et al. Different treatment outcomes of multiple sclerosis patients receiving Ocrelizumab or ofatumumab. Ann Neurol. 2025;97(3):583\u201395.","journal-title":"Ann Neurol"},{"issue":"7","key":"4519_CR36","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1001\/jamaneurol.2023.1184","volume":"80","author":"T Kalincik","year":"2023","unstructured":"Kalincik T, Sharmin S, Roos I, et al. Comparative effectiveness of autologous hematopoietic stem cell transplant vs Fingolimod, Natalizumab, and Ocrelizumab in highly active relapsing-remitting multiple sclerosis. JAMA Neurol. 2023;80(7):702\u201313.","journal-title":"JAMA Neurol"},{"issue":"3","key":"4519_CR37","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1056\/NEJMoa1606468","volume":"376","author":"X Montalban","year":"2017","unstructured":"Montalban X, Hauser SL, Kappos L, et al. Ocrelizumab versus placebo in primary progressive multiple sclerosis. N Engl J Med. 2017;376(3):209\u201320.","journal-title":"N Engl J Med"},{"issue":"8","key":"4519_CR38","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1136\/jnnp-2023-332883","volume":"95","author":"YC Foong","year":"2024","unstructured":"Foong YC, Merlo D, Gresle M, et al. Comparing ocrelizumab to interferon\/glatiramer acetate in people with multiple sclerosis over age 60. J Neurol Neurosurg Psychiatry. 2024;95(8):767\u201374.","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"4519_CR39","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2024.108249","volume":"240","author":"R Alroughani","year":"2024","unstructured":"Alroughani R, Al-Hashel J, Ahmed SF. Substantial and comparable suppression of disease activity following early initiation of cladribine tablets, Ocrelizumab or alemtuzumab as first pharmacologic treatment for relapsing multiple sclerosis: a real world study. Clin Neurol Neurosurg. 2024;240:108249.","journal-title":"Clin Neurol Neurosurg"},{"issue":"4","key":"4519_CR40","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1007\/s13760-025-02766-3","volume":"125","author":"N Mounir","year":"2025","unstructured":"Mounir N, Shalaby N, Hegazy MI, et al. Efficacy of ocrelizumab versus rituximab in patients with relapsing-remitting multiple sclerosis. Acta Neurol Belg. 2025;125(4):999\u20131006.","journal-title":"Acta Neurol Belg"}],"container-title":["BMC Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-025-04519-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12883-025-04519-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-025-04519-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T03:01:56Z","timestamp":1767150116000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12883-025-04519-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,21]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["4519"],"URL":"https:\/\/doi.org\/10.1186\/s12883-025-04519-4","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-7114838\/v1","asserted-by":"object"}]},"ISSN":["1471-2377"],"issn-type":[{"value":"1471-2377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,21]]},"assertion":[{"value":"13 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"As there was no direct human participation therefore no ethical approval was required.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"514"}}