{
  "abstract": "In JNNP, Konen et al provide real-world evidence that, in carefully selected stable patients with multiple sclerosis (MS), discontinuation of ocrelizumab after about 30 months was not associated with a statistically significant increase in inflammatory disease activity over a median follow-up of 28.5 months1, a relevant finding given that, although anti-CD20 therapies are highly effective in suppressing focal inflammatory activity, prolonged continuous B-cell depletion raises increasing concerns about hypogammaglobulinaemia, recurrent infections and impaired humoral vaccine responses.2 However, the CIs were wide, and disease activity showed a numerical increase beyond 24 months off treatment, arguing less for ‘safety’ than for cautious feasibility under structured surveillance.1 The next clinical question is therefore not only whether anti-CD20 therapy can be stopped, but how. Here, de-escalation may be more attractive than simple withdrawal in selected patients at higher infectious risk.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany"
      ],
      "name": "Marc Pawlitzki"
    },
    {
      "affiliations": [
        "Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany"
      ],
      "name": "Lars Masanneck"
    },
    {
      "affiliations": [
        "Centre for Neuroscience, Division of Experimental Medicine, Imperial College London, Hammersmith Hospital, London, UK"
      ],
      "name": "Antonio Scalfari"
    },
    {
      "affiliations": [
        "Blizard Institute, Queen Mary University of London, London, UK"
      ],
      "name": "Gavin Giovannoni"
    }
  ],
  "title": "Finite depletion, sustained control: can impulse therapy prevent rebound activity in multiple sclerosis?",
  "uid": "f7051cac-0ce9-5edc-a80a-55e3d3b71421"
}