000			03107nam a2200361 4500
001			ESSALUD
005			20260804123817.0
007			ta
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040			_aBMG
041			_aeng
100			_aTorkildsen, Øivind _eAutor _953663
245			_aRituximab versus ocrelizumab in newly diagnosed relapsing multiple sclerosis
300			_apáginas: 32-43
520			_aBackground: Anti-CD20 monoclonal antibodies are effective for relapsing multiple sclerosis. However, data from head-to-head trials are lacking. Methods: In this phase 3, multicenter, double-blind, noninferiority trial, we randomly assigned adults with newly diagnosed relapsing multiple sclerosis and recent disease activity in a 3:2 ratio to receive rituximab or ocrelizumab every 6 months for 24 months. The primary end point was the absence of new or enlarging lesions on T2-weighted magnetic resonance imaging (MRI) from month 6 to month 24. Noninferiority was defined as a lower limit of the 95% confidence interval for the risk difference (rituximab minus ocrelizumab) of greater than or equal to −10 percentage points. Secondary end points included efficacy and safety. Results: A total of 218 participants underwent randomization; 216 received treatment (132 assigned to the rituximab group and 84 assigned to the ocrelizumab group). Between months 6 and 24, the estimated probability of having no new or enlarging lesions detected on T2-weighted MRI was 92.2% with rituximab and 94.8% with ocrelizumab, corresponding to a risk difference of –2.6 percentage points (95% confidence interval, –9.4 to 4.3), which met the prespecified noninferiority criterion. Relapse rates, disability outcomes, and cognitive-performance profiles appeared to be similar in the two groups. Infections were more common in the rituximab group than in the ocrelizumab group (in 82% vs. 69% of participants), although the percentage of participants with serious adverse events was similar in the two groups (8% and 7%, respectively). Conclusions: In participants with newly diagnosed relapsing multiple sclerosis and recent disease activity, rituximab was noninferior to ocrelizumab in suppressing disease activity as detected by MRI from 6 to 24 months, with a similar incidence of serious adverse events.
650			_aALERGIA _97055
650			_aINMUNOLOGÍA GENERAL _953664
650			_aENFERMEDAD AUTOINMUNE _953665
650			_aMEDICINA CLINICA GENERAL _953666
650			_aENFERMEDAD INFLAMATORIA _953667
650			_aESCLEROSIS MULTIPLE _914091
650			_aNEUROLOGÍA
650			_aNEUROCIRUGÍA GENERAL _953668
650			_aOFTALMOLOGÍA _932364
700			_aKjelgaard Brustad, Hilde _953669
700			_aHøgestøl, Einar August _953670
700			_aAlstadhaug, Karl Bjørnar _953671
700			_aBhan, Alok _953672
700			_aFlemmen, Heidi Øyen _953673
700			_aHabbestad, Andrea _953674
773	0		_022717 _922634 _dMassachusetts NEJM Group _oNEJM001 _tThe New England Journal of Medicine _wESSALUD _x0028-4793
942			_cARTICULOS _e2026-07-31 _zsqb
999			_c22724 _d22724