{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:16:16Z","timestamp":1790072176231,"version":"4.0.1"},"reference-count":32,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T00:00:00Z","timestamp":1736985600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babes University of Medicine and Pharmacy Timisoara"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background and Objectives: Multiple sclerosis (MS) is a chronic autoimmune disorder characterized by inflammation and neurodegeneration. Ocrelizumab, a humanized anti-CD20 monoclonal antibody, has shown promise in reducing disease activity in MS patients. This prospective study aims to assess the effectiveness of ocrelizumab in reducing confirmed disability progression in patients with relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS) over a two-year period. By evaluating clinical data, and MRI findings, this study seeks to provide comprehensive insights into ocrelizumab\u2019s impact on disease dynamics and disability. Materials and Methods: Ninety-eight patients aged 18 to 65 with confirmed MS were enrolled under ocrelizumab therapy at the Neurology Department of \u201cPius Brinzeu\u201d Clinical Emergency Hospital in Romania between July 2020 and July 2024. Participants were assessed at baseline and every six months over two years. The key outcomes measured were changes in the Expanded Disability Status Scale (EDSS) as a measure of confirmed disability progression (CDP), annualized relapse rate (ARR), and MRI findings. Results: Over the two-year period, the mean EDSS score significantly decreased from 5.2 \u00b1 1.8 to 4.6 \u00b1 1.7 (mean change = \u22120.6 \u00b1 0.9; p = 0.032), indicating improved neurological function. The proportion of patients experiencing relapses dropped markedly from 61.2% to 14.3% (p &lt; 0.001). The MRI results showed significant reductions in patients with new or enlarging T2 lesions from 68.4% to 27.6% (p &lt; 0.001) and gadolinium-enhancing lesions from 44.9% to 15.3% (p &lt; 0.001). Patients previously treated with natalizumab exhibited a greater reduction in EDSS scores (\u22121.0 \u00b1 0.8; p = 0.001) compared to other treatments. Multivariate regression identified the baseline EDSS score (\u03b2 = 0.65; p &lt; 0.001), previous natalizumab use (\u03b2 = \u22120.30; p = 0.013), and age at diagnosis (\u03b2 = 0.02; p = 0.048) as significant predictors of two-year EDSS scores. While markers of active inflammation decreased, the proportion of patients with brain atrophy increased from 31.6% to 43.9% (not statistically significant; p = 0.105). SPMS patients had higher rates of brain atrophy at baseline (61.1% vs. 25.0%; p = 0.007) and at two years (100.0% vs. 31.3%; p &lt; 0.001) compared to RRMS patients. Conclusions: Ocrelizumab effectively reduced disease activity and improved neurological disability over two years in both RRMS and SPMS patients. Significant reductions in relapse rates and MRI markers of inflammation were observed. Previous natalizumab treatment was associated with greater improvements. Despite these benefits, the progression of neurodegeneration, particularly brain atrophy in SPMS patients, underscores the need for additional strategies targeting neurodegenerative aspects of MS.<\/jats:p>","DOI":"10.3390\/jcm14020553","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T10:44:23Z","timestamp":1737024263000},"page":"553","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effectiveness of Ocrelizumab on Disease Progression and Disability Status in Multiple Sclerosis Patients: A Two-Year Prospective Cohort Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Amanda Claudia","family":"Schuldesz","sequence":"first","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1971-6901","authenticated-orcid":false,"given":"Raluca","family":"Tudor","sequence":"additional","affiliation":[{"name":"Discipline of Neurology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7293-3414","authenticated-orcid":false,"given":"Amalia","family":"Cornea","sequence":"additional","affiliation":[{"name":"Discipline of Neurology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorina Nicola","family":"Geni","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina Nicoleta","family":"Lata","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela","family":"Simu","sequence":"additional","affiliation":[{"name":"Discipline of Neurology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1016\/S0140-6736(08)61620-7","article-title":"Multiple sclerosis","volume":"372","author":"Compston","year":"2008","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1038\/s41572-018-0041-4","article-title":"Multiple sclerosis","volume":"4","author":"Filippi","year":"2018","journal-title":"Nat. Rev. Dis. Primers."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1056\/NEJMra1401483","article-title":"Multiple Sclerosis","volume":"378","author":"Reich","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1056\/NEJMoa1606468","article-title":"Ocrelizumab versus Placebo in Primary Progressive Multiple Sclerosis","volume":"376","author":"Montalban","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1056\/NEJMoa1601277","article-title":"Ocrelizumab versus Interferon Beta-1a in Relapsing Multiple Sclerosis","volume":"376","author":"Hauser","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/s40265-022-01672-9","article-title":"Ocrelizumab: A Review in Multiple Sclerosis","volume":"82","author":"Lamb","year":"2022","journal-title":"Drugs"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1097\/WCO.0000000000001262","article-title":"Understanding multiple sclerosis as a disease spectrum: Above and below the clinical threshold","volume":"37","author":"Krieger","year":"2024","journal-title":"Curr. Opin. Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Zaratin, P., Samadzadeh, S., Sefero\u011flu, M., Ricigliano, V., Dos Santos Silva, J., Tunc, A., Brichetto, G., Coetzee, T., Helme, A., and Khan, U. (2024). The global patient-reported outcomes for multiple sclerosis initiative: Bridging the gap between clinical research and care\u2014Updates at the 2023 plenary event. Front. Neurol., 15.","DOI":"10.3389\/fneur.2024.1407257"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"G\u00f3mez-Melero, S., Caballero-Villarraso, J., Escribano, B.M., Galvao-Carmona, A., T\u00fanez, I., and Ag\u00fcera-Morales, E. (2024). Impact of Cognitive Impairment on Quality of Life in Multiple Sclerosis Patients\u2014A Comprehensive Review. J. Clin. Med., 13.","DOI":"10.3390\/jcm13113321"},{"key":"ref_10","first-page":"55","article-title":"Interventions to Improve Quality of Life in Multiple Sclerosis: New Opportunities and Key Talking Points","volume":"13","author":"Faraclas","year":"2023","journal-title":"Degener. Neurol. Neuromuscul. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"353","DOI":"10.2147\/PROM.S156279","article-title":"The importance of patient-reported outcomes in clinical trials and strategies for future optimization","volume":"9","author":"King","year":"2018","journal-title":"Patient Relat. Outcome Meas."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1177\/1756285617708911","article-title":"MRI in the assessment and monitoring of multiple sclerosis: An update on best practice","volume":"6","author":"Kaunzner","year":"2017","journal-title":"Ther. Adv. Neurol. Disord."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e480","DOI":"10.1212\/NXI.0000000000000480","article-title":"Gd contrast administration is dispensable in patients with MS without new T2 lesions on follow-up MRI","volume":"5","author":"Wildemann","year":"2018","journal-title":"Neurol. Neuroimmunol. Neuroinflamm."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1002\/acn3.51732","article-title":"Real-world evaluation of ocrelizumab in multiple sclerosis: A systematic review","volume":"3","author":"Montalban","year":"2023","journal-title":"Ann. Clin. Transl. Neurol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1756286420975223","DOI":"10.1177\/1756286420975223","article-title":"Factors influencing daily treatment choices in multiple sclerosis: Practice guidelines, biomarkers and burden of disease","volume":"13","author":"Berger","year":"2020","journal-title":"Ther. Adv. Neurol. Disord."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/S1474-4422(17)30470-2","article-title":"Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria","volume":"2","author":"Thompson","year":"2018","journal-title":"Lancet Neurol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"102724","DOI":"10.1016\/j.msard.2020.102724","article-title":"Disability measurement in Multiple Sclerosis patients 55 years and older: What is the Expanded Disability Status Scale really telling clinicians?","volume":"49","author":"Lynch","year":"2021","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1007\/s00415-023-12047-9","article-title":"Increasing age of multiple sclerosis onset from 1920 to 2022: A population-based study","volume":"4","author":"Habbestad","year":"2024","journal-title":"J. Neurol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1007\/s00062-015-0430-y","article-title":"MRI in the Diagnosis and Monitoring of Multiple Sclerosis: An Update","volume":"25","author":"Wattjes","year":"2015","journal-title":"Clin. Neuroradiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"17562864221142924","DOI":"10.1177\/17562864221142924","article-title":"Comparative effectiveness of natalizumab versus ocrelizumab in multiple sclerosis: A real-world propensity score-matched study","volume":"15","author":"Pape","year":"2022","journal-title":"Ther. Adv. Neurol. Disord."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1007\/s40120-023-00475-8","article-title":"Efficacy of Dimethyl Fumarate in Young Adults with Relapsing-Remitting Multiple Sclerosis: Analysis of the DEFINE, CONFIRM, and ENDORSE Studies","volume":"3","author":"Amezcua","year":"2023","journal-title":"Neurol. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"5382","DOI":"10.1007\/s00415-022-11193-w","article-title":"Early use of high-efficacy disease-modifying therapies makes the difference in people with multiple sclerosis: An expert opinion","volume":"269","author":"Filippi","year":"2022","journal-title":"J. Neurol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1097\/WNN.0000000000000200","article-title":"Changes in Cognitive Performance with Age in Adults with Multiple Sclerosis","volume":"32","author":"Baird","year":"2019","journal-title":"Cogn. Behav. Neurol."},{"key":"ref_24","first-page":"20552173211007523","article-title":"The impact of ocrelizumab on health-related quality of life in individuals with multiple sclerosis","volume":"7","author":"Glanz","year":"2021","journal-title":"Mult. Scler. J. Exp. Transl. Clin."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"120","DOI":"10.17116\/jnevro2019119102120","article-title":"Izmeneniia kachestva zhizni patsientov s rasseiannym sklerozom na fone kursa lecheniia okrelizumabom [Changes in the quality of life in patients with multiple sclerosis treated with ocrelizumab]","volume":"119","author":"Boyko","year":"2019","journal-title":"Zh. Nevrol. Psikhiatr. Im. S S Korsakova."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"104006","DOI":"10.1016\/j.msard.2022.104006","article-title":"Estimating the association between physical activity and health-related quality of life in individuals with multiple sclerosis","volume":"65","author":"Healy","year":"2022","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"21","DOI":"10.2217\/nmt-2023-0047","article-title":"Comparison of time to clinically meaningful improvement in quality of life in neurological disorders in patients treated with natalizumab versus ocrelizumab","volume":"14","author":"Hersh","year":"2024","journal-title":"Neurodegener. Dis. Manag."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"105003","DOI":"10.1016\/j.msard.2023.105003","article-title":"Association between PROMIS10, SF-36 and NeuroQoL in persons with multiple sclerosis","volume":"79","author":"Healy","year":"2023","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"104109","DOI":"10.1016\/j.msard.2022.104109","article-title":"Efficacy, safety and patient reported outcomes in patients with active relapsing multiple sclerosis treated with ocrelizumab: Final results from the PRO-MSACTIVE study","volume":"68","author":"Manchon","year":"2022","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Barcutean, L., Maier, S., Bajko, Z., Stoian, A., Mosora, O., Sarmasan, E., Manescu, I.B., and Balasa, R. (2024). Long-Term Disability Outcomes in Relapsing-Remitting Multiple Sclerosis Patients: Impact of Clinical and Demographic Factors on Disease Progression. J. Clin. Med., 13.","DOI":"10.3390\/jcm13061813"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"6782","DOI":"10.1007\/s00415-024-12638-0","article-title":"Disability trajectories by progression independent of relapse activity status differ in pediatric, adult and late-onset multiple sclerosis","volume":"271","author":"Simone","year":"2024","journal-title":"J. Neurol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"105345","DOI":"10.1016\/j.msard.2023.105345","article-title":"Ocrelizumab in highly disabled progressive multiple sclerosis patients","volume":"82","author":"Houtchens","year":"2024","journal-title":"Mult. Scler. Relat. Disord."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/2\/553\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:29:59Z","timestamp":1759919399000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/2\/553"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,16]]},"references-count":32,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["jcm14020553"],"URL":"https:\/\/doi.org\/10.3390\/jcm14020553","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,16]]}}}