{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T23:51:15Z","timestamp":1773100275237,"version":"3.50.1"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T00:00:00Z","timestamp":1709164800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Drug-induced liver injury (DILI) is a potential adverse event of disease-modifying therapies (DMTs) for the treatment of multiple sclerosis (MS), as well as of methylprednisolone pulsed therapy used in case of MS relapse. DILI may be induced by different mechanisms, including idiosyncratic reaction, autoimmune hepatitis or viral reactivation. In patients receiving the humanized anti-CD20 monoclonal antibody (mAb) ocrelizumab, DILI has been rarely reported and was mostly associated with hepatitis B virus (HBV) reactivation. Here we present the case of a woman with highly active relapsing\u2013remitting MS who had experienced two episodes of DILI while receiving different DMTs, and was successfully switched to ofatumumab, a fully human anti-CD20 mAb, after a further event associated with ocrelizumab treatment and unrelated to HBV reactivation. Despite sharing the mechanism of action, differences in structure, pharmacokinetic\/pharmacodynamic profile, and use of ancillary drugs (only needed for ocrelizumab) may have accounted for the successful switch. To our knowledge, this is the first report of a successful switch from ocrelizumab to ofatumumab due to DILI. Ofatumumab may therefore represent a valid therapeutic option for patients experiencing DMTs- and ocrelizumab-induced liver injury, providing that HBV reactivation has been ruled out.<\/jats:p>","DOI":"10.3389\/fneur.2024.1363493","type":"journal-article","created":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T04:55:53Z","timestamp":1709182553000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Successful switch to ofatumumab after liver injury associated with ocrelizumab treatment in multiple sclerosis: a case report"],"prefix":"10.3389","volume":"15","author":[{"given":"Alice","family":"Mariottini","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Barilaro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Lotti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Marra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Massacesi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,2,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1007\/s40263-021-00842-9","article-title":"The disease-modifying therapies of relapsing-remitting multiple sclerosis and liver injury: a narrative review","volume":"35","author":"Biolato","year":"2021","journal-title":"CNS Drugs"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1622","DOI":"10.1016\/S0140-6736(18)30481-1","article-title":"Multiple sclerosis","volume":"391","author":"Thompson","year":"2018","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1633","DOI":"10.1177\/1352458518799598","article-title":"Liver injury with drugs used for multiple sclerosis: a contemporary analysis of the FDA adverse event reporting system","volume":"25","author":"Antonazzo","year":"2019","journal-title":"Mult Scler J"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e00968","DOI":"10.1002\/brb3.968","article-title":"Liver injury after pulsed methylprednisolone therapy in multiple sclerosis patients","volume":"8","author":"Nociti","year":"2018","journal-title":"Brain Behav"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1177\/13524585231213230","article-title":"The disease-modifying therapy utilisation and cost trend for multiple sclerosis in Australia between 2013 and 2022","volume":"30","author":"Zhao","year":"2023","journal-title":"Mult Scler J"},{"key":"ref6","year":""},{"key":"ref7","year":""},{"key":"ref8","doi-asserted-by":"publisher","first-page":"4288","DOI":"10.3390\/jcm11154288","article-title":"Relevance of pathogenetic mechanisms to clinical effectiveness of B-cell-depleting monoclonal antibodies in multiple sclerosis","volume":"11","author":"Massacesi","year":"2022","journal-title":"J Clin Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1177\/1352458516657441","article-title":"Measuring treatment satisfaction in MS: is the treatment satisfaction questionnaire for medication fit for purpose?","volume":"23","author":"Vermersch","year":"2017","journal-title":"Mult Scler J"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"852","DOI":"10.3390\/ijms24010852","article-title":"Hepatotoxicity of drugs used in multiple sclerosis, diagnostic challenge, and the role of HLA genotype susceptibility","volume":"24","author":"Meunier","year":"2023","journal-title":"Int J Mol Sci"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1222","DOI":"10.1016\/j.jhep.2019.02.014","article-title":"EASL clinical practice guidelines: drug-induced liver injury","volume":"70","year":"2019","journal-title":"J Hepatol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1038\/clpt.2011.58","article-title":"Case definition and phenotype standardization in drug-induced liver injury","volume":"89","author":"Aithal","year":"2011","journal-title":"Clin Pharmacol Therap"},{"key":"ref13","volume-title":"LiverTox: Clinical and research information on drug-induced liver injury internet","year":"2012"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e1898","DOI":"10.14309\/01.ajg.0000868304.44094.3b","article-title":"S2916 a rare case of refractory drug induced liver injury following Ocrelizumab use for multiple sclerosis","volume":"117","author":"Ibrahim","year":"2022","journal-title":"Am Coll Gastroenterol"},{"key":"ref15","author":"Harata","year":"2023"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1111\/his.15120","article-title":"Histologic manifestations of ocrelizumab-associated intestinal and hepatic injury in patients with multiple sclerosis","author":"Challa","year":"2023","journal-title":"Histopathology"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1297","DOI":"10.1053\/j.gastro.2017.02.009","article-title":"Hepatitis B reactivation associated with immune suppressive and biological modifier therapies: current concepts, management strategies, and future directions","volume":"152","author":"Loomba","year":"2017","journal-title":"Gastroenterology"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1001\/jamaneurol.2023.1542","article-title":"Comparison between dimethyl fumarate, Fingolimod, and Ocrelizumab after Natalizumab cessation","volume":"80","author":"Zhu","year":"2023","journal-title":"JAMA Neurology"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"2121","DOI":"10.1007\/s10072-023-06608-z","article-title":"The comparative effectiveness of fingolimod, natalizumab, and ocrelizumab in relapsing-remitting multiple sclerosis","volume":"44","author":"Boz","year":"2023","journal-title":"Neurol Sci"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"688","DOI":"10.1002\/ana.25701","article-title":"Cancer risk for Fingolimod, Natalizumab, and rituximab in multiple sclerosis patients","volume":"87","author":"Alping","year":"2020","journal-title":"Ann Neurol"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2024.1363493\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T04:55:55Z","timestamp":1709182555000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2024.1363493\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,29]]},"references-count":20,"alternative-id":["10.3389\/fneur.2024.1363493"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2024.1363493","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,29]]},"article-number":"1363493"}}