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Comparative effectiveness of anti-CD20 therapies and S1P receptor modulators in late-onset multiple sclerosis: real-world evidence from the MSBase registry
Journal article   Open access   Peer reviewed

Comparative effectiveness of anti-CD20 therapies and S1P receptor modulators in late-onset multiple sclerosis: real-world evidence from the MSBase registry

Andrea Surcinelli, Tomas Kalincik, Izanne Roos, Emanuele D’Amico, Jeannette Lechner-Scott, Serkan Ozakbas, Pavel Hradilek, Dana Horáková, Marta Vachova, Ivan Panzera, …
Therapeutic advances in neurological disorders, Vol.19
2026
DOI: https://doi.org/10.1177/17562864261430084
PMID: 41919069
pdf
Published1.13 MBDownloadView
Open Access CC BY-NC V4.0

Abstract

Original Research
How two main treatments for late-onset multiple sclerosis compare in real life Multiple sclerosis (MS) is a disease where the immune system attacks the brain and spinal cord. When MS begins after the age of 50, it is called late-onset multiple sclerosis (LOMS). This form of MS can progress faster and respond differently to treatment compared to cases that start earlier in life. In this study, we compared two important groups of modern MS treatments: - Anti-CD20 therapies, which target specific immune cells, and - S1P receptor modulators, which prevent immune cells from reaching the brain. We analysed real-world data from an international MS registry called MSBase, including people with relapsing LOMS who had used one of these therapies for at least six months. We looked at how often relapses occurred, how disability changed over time, and whether disability increased independently of relapses. The results showed that, overall, both treatment types worked similarly in preventing relapses and disability worsening. However, in some patients—especially those younger than 55, with early disease and lower disability—anti-CD20 therapies appeared to have a small advantage. These findings suggest that both therapies are effective for most people with late-onset MS, but that starting anti-CD20 treatment early may be beneficial for selected patients. This information can help doctors personalise treatment plans for older adults living with MS.

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