{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T20:55:05Z","timestamp":1780433705748,"version":"3.54.1"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The MS population is aging, with nearly one-third now over 55 years. This group is underrepresented in trials and less often prescribed high-efficacy therapy (HET). Although phase III studies of ocrelizumab and ofatumumab confirmed efficacy in younger patients, the risk\u2013benefit profile in older people with MS (opwMS) is less established given reduced relapse activity and higher risks of infection and malignancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed opwMS (\u2265 55 years) treated with ocrelizumab or ofatumumab at a tertiary centre, evaluating clinical outcomes, MRI activity, and adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 140 patients (67% (94) female, mean age 63), median disease duration was 16 years and B-cell therapy duration 44 months; 91% (127) had prior DMT exposure. During treatment, 77.9% (109) achieved NEDA-3, EDSS remained stable (3.38 to 3.44, p=0.67), and PIRA was reduced by 15%. Adverse events occurred in 50.7% (71%), leading to discontinuation in 10.7% (15). Immunoglobulin levels fell significantly (IgM, IgA, and IgG). In 47 patients \u2265 65 years, adverse event rates were similar, 69.6% (33) achieved NEDA-3, but EDSS increased (p=0.034).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Over 44 months, B-cell therapy in opwMS (mean age 63) showed safety and efficacy comparable with younger cohorts, although immunoglobulin decline and discontinuation due to adverse effects highlight the need for monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2025.1699550","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T12:48:53Z","timestamp":1769604533000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Safety and efficacy of B-cell therapy in older people with multiple sclerosis"],"prefix":"10.3389","volume":"16","author":[{"given":"Turlough","family":"Montague","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuuki","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Burke Simpson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celia","family":"Miller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Chatterton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariadna","family":"Fontes Villalba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Parratt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-024-12286-4","article-title":"Persons with multiple sclerosis older than 55 years: an analysis from the German MS registry","volume":"271","author":"Goereci","year":"2024","journal-title":"J Neurol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007035","article-title":"The prevalence of MS in the United States: a population-based estimate using health claims data","volume":"92","author":"Wallin","year":"2019","journal-title":"Neurology"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000209461","article-title":"Clinical characteristics and long-term outcomes of late-onset multiple sclerosis: A Swedish nationwide study","volume":"103","author":"Mouresan","year":"2024","journal-title":"Neurology"},{"key":"B4","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1007\/s11910-020-01046-2","article-title":"Impact of age on multiple sclerosis disease activity and progression","volume":"20","author":"Zeydan","year":"2020","journal-title":"Curr Neurol Neurosci Rep"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-025-01115-5","article-title":"International Advisory Committee Clinical Trials in MS Workshop on Ageing and MS members. 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