Abstract
The US Food and Drug Administration (FDA) recently issued a warning regarding ocrelizumab
due to reports of colitis among patients taking this medication. Since it is the only
FDA-approved therapy for primary progressive multiple sclerosis (PPMS), further research
on this adverse event is necessary, and healthcare professionals should be informed
of potential treatment options. In this review, we summarize the available data on
the incidence of inflammatory colitis associated with anti-CD20 monoclonal antibodies
(mAbs), such as ocrelizumab and rituximab, used in MS treatment. Although the exact
pathophysiology of anti-CD20-induced colitis remains unknown, immunological dysregulation
through treatment-mediated B-cell depletion has been proposed as a possible mechanism.
Our study highlights the importance of clinicians being aware of this potential side
effect, and patients taking these medications should be closely monitored for any
new-onset gastrointestinal symptoms or diarrheal illness. Research indicates that
prompt intervention with endoscopic examination and medical or surgical therapies
can ensure timely and effective management, thus improving patient outcomes. However,
large-scale studies are still needed to determine the associated risk factors and
to establish definitive guidelines for the clinical evaluation of MS patients on anti-CD20
medications.
Keywords
Abbreviations:
MS (multiple sclerosis), PPMS (primary progressive MS), RRMS (relapsing remitting MS), CD20 (cluster of differentiation 20), MABS (monoclonal antibodies), IBD (inflammatory bowel disease), UC (ulcerative colitis), CNS (central nervous system), Th17 (T helper 17), Treg (regulatory T cells), IL (interleukin), EAE (experimental autoimmune encephalomyelitis)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 14, 2023
Accepted:
May 14,
2023
Received in revised form:
May 4,
2023
Received:
January 15,
2023
Identification
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© 2023 Elsevier B.V. All rights reserved.
