Giancarlo Comi, MD, Vita-Salute San Raffaele University, Milan, Italy, talks on the use of B-cell targeting agents in multiple sclerosis (MS) and why they are an efficacious treatment option. Traditionally, MS was considered a disease of the central nervous system, driven primarily by CD4+ T-cells. However, increasing evidence has accumulated over time that has implicated B-cells as a major factor in the pathogenesis of MS. Prof. Comi highlights ORATORIO (NCT01194570) and the OPERA I (NCT01247324) and II (NCT01412333) trials of ocrelizumab in relapsing MS as providing major evidence for the relevance of B-cells in the underlying mechanisms of MS, spurring lots of research into this area. It is now realized that B-cell contribute not only via antibody production, but also through pro-inflammatory cytokine production, antigen presentation, T-cell activation, and cortical lesion formation. This interview took place during the European Academy of Neurology 2021 congress.
Giancarlo Comi has received consulting and speaking fees from Novartis, Sanofi Genzyme, Genzyme Corporation, Merck KGgA, Merck Serono SpA, Celgene Group, F. Hoffman-La Roche, Almirall SpA, & Janssen.