b"Medicine & ResearchDoctors NotesThe MS News column includes analysis from Ben Thrower, M.D., MS Focus senior medical advisor. He draws from the top news stories of the quarter and explains what the news means to you, the person with MS. Christine Willis, MLIS, AHIP, is the Clinical Information Librarian at Children's Healthcare of Atlanta, Egleston Hospital.Study examines DMT, antibody linkThe CD20 receptor is present on the surface Researchers from four research institutionsof B-cells and is the target for these therapies. and the Novartis Pharmaceuticals corporationOne of the roles for B-cells is antibody production. conducted a literature review of possibleAnti-CD20 MABs can be linked to a decrease mechanisms of secondary hypogamma- in antibody production, a condition called globulinemia in patients with MS, hypogamma- hypogammaglobulinemia. Antibody status can globulinemia results in MS anti-CD20 therapybe checked by measuring IgG and IgM levels clinical trials, the risk of infection for patientsin the blood. In general, people with MS who with hypogammaglobulinemia, and possibleare on an anti-CD20 MAB should have periodic strategies for disease management. Sixteenantibody levels drawn to rule out hypogama-articles describing clinical trials and evidenceglobulinemia and lower the risk infections studies were reviewed for immuno-globulinsuch as UTIs or respiratory infections. If you G levels as well as 15 articles discussingdevelop hypogammaglobulinemia from an immunoglobulin M levels and the correspondinganti-CD20 therapy, your MS healthcare team lower limit of normal for each since secondarycandiscussnextsteps.Thismayinvolve hypogammaglobulinemia usually affects thesechangesinthedoseorfrequencyofyour levels. The researchers were able to draw sometherapy or a switch in therapy altogether.conclusions about the effect of therapies, butResearchers put focus on PIRAevidence-based guidelines are lacking, whichA cohort of researchers in Switzerland necessitates further research. The study wassought to summarize the current evidence published in the journal Multiple Sclerosisabout progression independent of relapse and Related Disorders.activity based on a systematic review of 48 Thrower -Anti-CD20 monoclonal antibodieseligible studies. PIRA was reported to occur in represent one of the most effective classes ofroughly 5 percent of all patients with RRMS therapiesforrelapsingformsofMS.Thisper year, causing at least 50 percent of all therapeutic class includes rituximab (Rituxan,disability accrual events in typical RRMS. The Truxima, Ruxience, and Riabni), ocrelizumabproportion of PIRA versus relapse-associated (Ocrevus), ofatumumab (Kesimpta) andworsening increased with age, longer disease ublituximab (Briumvi). These MABs work byduration, and, despite lower absolute event depleting a population of B-cells in the immunenumbers, potent suppression of relapses by system resulting in decreased inammation.highly effective disease-modifying therapy. msfocusmagazine.org 46"