Therapies Compared for Newly Diagnosed Multiple Sclerosis

B-cell-depleting therapy linked to lower relapse incidence, greater T2 lesion volume reduction compared with oral platform therapies



THURSDAY, Sept. 10, 2026 (HealthDay News) — For patients with newly diagnosed multiple sclerosis (MS), B-cell-depleting therapies (BCDTs) and high-efficacy therapies have greater effects on acute inflammatory outcomes than progression-related outcomes, according to a study published online Sept. 9 in Neurology Open Access.

Paula Uibel, from the Technical University of Munich, and colleagues compared two-year clinical, radiologic, and biomarker outcomes across disease-modifying therapies in adults with newly diagnosed relapsing or progressive MS who were enrolled at nine European centers. Participants were categorized by initial therapy into injectable platform, oral platform, high-efficacy therapies, BCDTs, or no treatment (17.1, 29.9, 15.5, 19.8, and 17.7 percent, respectively).

Overall, 455 of the 509 participants completed follow-up. The researchers found that BCDT was associated with lower relapse incidence compared with oral platform therapies (incidence rate ratio, 0.38) and greater T2 lesion volume reduction (volume ratio, 0.87); similar trends were seen for high-efficacy therapies. No differences were seen between the groups in changes in the Expanded Disability Status Scale or serum neurofilament light chain. There was a modest decrease overall in serum glial fibrillary acidic protein z-scores; reductions were larger in the oral platform group and levels were relatively higher in BCDT and high-efficacy groups. Higher persistence was seen with BCDT (93.8 versus 72.3 percent).

“B-cell-depleting therapies and other strong treatments were linked to fewer relapses and fewer magnetic resonance imaging changes,” coauthor Fredrik Piehl, M.D., Ph.D., of the Karolinska Institutet in Stockholm, said in a statement. “But after two years, we did not see clear differences in disability scores.”

Several authors disclosed ties to the biopharmaceutical industry.

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