Which MS Drug Works Better After Stopping S1P Medicines?

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Key Takeaway

After stopping S1P-modulator treatment, the injected drug ofatumumab was linked to fewer relapses and less MRI and disability worsening than intravenous ocrelizumab in this real-world study.

What They Found

Researchers looked at 225 adults with relapsing-remitting MS who switched from an S1P-modulator drug to either ofatumumab (a monthly injection) or ocrelizumab (an IV infusion). People who started ofatumumab had fewer relapses per year and a lower chance of having a relapse over time compared with those who started ocrelizumab. MRI scans showed less new disease activity overall in the ofatumumab group, meaning fewer new or active spots in the brain on average. Measures of disability over the follow-up period tended to be better with ofatumumab (a small average improvement on the usual disability score), while some specific disability outcomes were similar between the drugs. Serious side effects were rare with both treatments, and most people stayed on treatment, though time on ofatumumab was somewhat shorter in this group.

Who Should Care and Why

People with RRMS who are stopping an S1P-modulator (for example, fingolimod) and need to start an anti-CD20 therapy should pay attention, because this study suggests ofatumumab may better prevent early return of disease activity. Caregivers and family members may find injections (ofatumumab) easier to manage at home than IV infusions, which require clinic visits—this can matter for planning and daily life. Neurologists and MS nurses might use this information when choosing the next treatment after an S1P drug, especially when quick protection against relapses is important. Patients worried about disease coming back after stopping an S1P drug could discuss the timing of the switch and the option of ofatumumab with their care team, since shorter gaps between treatments were included in the study. However, individual factors like past infections, pregnancy plans, and other health issues still matter when picking a drug.

Important Considerations

This study looked back at medical records (not a randomized trial), so the two groups might differ in ways that weren’t fully measured even though statistical methods were used to balance them. The number of people is modest and they were from specialized centers in Italy, so results might not apply exactly the same way to every person with MS or in every country. Also, while the study suggests benefits for ofatumumab after S1P drugs, it cannot prove cause-and-effect the way a randomized trial would, so discuss these findings with your neurologist before making treatment decisions.

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Treatment Updates Clinical Trials Living with MS

Whether you’ve recently been diagnosed with Multiple Sclerosis (MS) or are seeking to broaden your understanding of this complex, neurodegenerative disease, navigating the latest research can feel overwhelming. Studies published in respected medical journals like CNS drugs often range from early-stage, exploratory work to advanced clinical trials. These evidence-based findings help shape new disease-modifying therapies, guide symptom management techniques, and deepen our knowledge of MS progression.

However, not all research is created equal. Some clinical research studies may have smaller sample sizes, evolving methodologies, or limitations that warrant careful interpretation. For a more comprehensive, accurate understanding, we recommend reviewing the original source material—accessible via the More Details section above—and consulting with healthcare professionals who specialize in MS care.

By presenting a wide range of MS-focused studies—spanning cutting-edge treatments, emerging therapies, and established best practices—we aim to empower patients, caregivers, and clinicians to stay informed and make well-informed decisions when managing Multiple Sclerosis.

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