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Update on B cells in MS pathophysiology

…), which may have a bearing on B cell distribution in the different CNS sub-compartments (parenchyma, meninges, CSF), but this area requires further study. B cell depletion results in a rapid decrease in disease activity, as shown in trials of anti-CD20 agents. In the OPERA studies, the median number of CD19+ cells was reduced >95% within two weeks of the first infusion (Hauser et al. N Engl J Med 2017;376:221-234, supplemental appendix). The numb…

Cognitive dysfunction in MS: Update from EAN

…d that only 43% of MS patients scored within the normal range on all three tests compared to 83% of healthy controls (O’Connell et al. Mult Scler Relat Disord 2015;4:521-525). At the 5-year follow-up (mean age 49 years), cognitive function appeared to have stabilized: there was no change in SDMT and there were significant improvements in BVMT-R and CVLT (Gaughan et al. EAN 2020; abstract EPR1177). Subjects also demonstrated no change in anxiety sc…

SPMS: new data and developments

…l. CMSC 2020; abstract DXT10). In the subgroup of patients who were relapse-free in the 1 year prior to entry, there was a 25% reduction in 6-month confirmed disability progression with siponimod versus placebo. Also noteworthy were the results from the EXPAND extension study (Kappos et al. EAN 2020; abstract EPR2128). For patients on continuous siponimod, an estimated 59% had no 6-month confirmed disability worsening and 68% had no confirmed cogn…