44 patients were included [27 females, median age 46 (36-55) years, 14 switchers, 30 continuers] and followed over 3.1 years.
In the CLAD group, IgG remained stable (median change: CLAD-group=-0.08 [-0.73-0.88], p=0.944; antiCD20-group=-0.33[-1.28-0.47], p=0.142), with a trend towards less reduction over time in IgG in CLAD-group versus antiCD20-group (time*treatment group: β=0.04; p=0.093). IgM remained stable in CLAD-group (median change=0.02 [-0.08-0.16], p=0.551), while decreasing in antiCD20-group (-0.12[-0.22-0.03], p<0.001), with significant time*treatment group interaction (β=0.10 p<0.001).
Thirty-seven adverse events occurred in antiCD20-group and 18 in CLAD-group, the most common being mild-moderate infections. Five (35.7%) patients in CLAD-group and 4(12.9%) in antiCD20-group had EDSS worsening. No relapses occurred. One patient in CLAD-group had a new T2 spinal lesion; one had a new brain T2 lesion and 2 new T2 spinal lesions in antiCD20-group.
NfL Z scores decreased over time in antiCD20-group, while they remained stable in CLAD-group (treatment*time interaction β= 0.35, p=0.005). GFAP Z scores decreased with time in the overall group (β= -0.32, p<0.001), with no significant difference based on treatment (treatment*time interaction β= 0.20, p=0.107).