Quantifying the Impact of Ocrelizumab on Paramagnetic Rim Lesions in Multiple Sclerosis

Kimberly H. Markowitz; Neha V. Safi; Iliana Pliska-Bloch; Ulrike W. Kaunzner; Ha Luu; Yi Wang; Thanh D. Nguyen; Sandra M. Hurtado Rua; Susan A. Gauthier

doi:10.1002/acn3.70357

Quantifying the Impact of Ocrelizumab on Paramagnetic Rim Lesions in Multiple Sclerosis

Kimberly H. Markowitz
, Neha V. Safi
, Iliana Pliska-Bloch
, Ulrike W. Kaunzner
, Ha Luu
, Yi Wang
, Thanh D. Nguyen
, Sandra M. Hurtado Rua
, Susan A. Gauthier

Weill Cornell Medical College
Weill Cornell Medicine Feil Family Brain & Mind Research Institute

Research output: Contribution to journal › Article › peer-review

Abstract

Paramagnetic rim lesions (PRLs) are a subset of chronic active multiple sclerosis (MS) lesions marked by iron-laden microglia and macrophages. Ocrelizumab, a monoclonal antibody targeting CD20+ B cells, suppresses acute MS activity, but its effect on PRLs remains unclear. In a longitudinal study of 29 ocrelizumab-treated patients with at least one PRL on quantitative susceptibility mapping (QSM), 97 PRLs were identified. Before treatment, PRLs showed higher QSM values than non-PRLs (p = 0.001), indicating iron enrichment. After treatment, PRLs demonstrated a greater QSM reduction (p < 0.001), with an accelerated decline in susceptibility. These findings suggest ocrelizumab may attenuate iron-related inflammation in PRLs.

Original language	English
Journal	Annals of Clinical and Translational Neurology
Volume	n/a
Issue number	n/a
DOIs	https://doi.org/10.1002/acn3.70357
State	Accepted/In press - Jan 1 2026

Keywords

multiple sclerosis
ocrelizumab
quantitative susceptibility mapping

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10.1002/acn3.70357

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title = "Quantifying the Impact of Ocrelizumab on Paramagnetic Rim Lesions in Multiple Sclerosis",

abstract = "Paramagnetic rim lesions (PRLs) are a subset of chronic active multiple sclerosis (MS) lesions marked by iron-laden microglia and macrophages. Ocrelizumab, a monoclonal antibody targeting CD20+ B cells, suppresses acute MS activity, but its effect on PRLs remains unclear. In a longitudinal study of 29 ocrelizumab-treated patients with at least one PRL on quantitative susceptibility mapping (QSM), 97 PRLs were identified. Before treatment, PRLs showed higher QSM values than non-PRLs (p = 0.001), indicating iron enrichment. After treatment, PRLs demonstrated a greater QSM reduction (p < 0.001), with an accelerated decline in susceptibility. These findings suggest ocrelizumab may attenuate iron-related inflammation in PRLs.",

keywords = "multiple sclerosis, ocrelizumab, quantitative susceptibility mapping",

author = "Markowitz, \{Kimberly H.\} and Safi, \{Neha V.\} and Iliana Pliska-Bloch and Kaunzner, \{Ulrike W.\} and Ha Luu and Yi Wang and Nguyen, \{Thanh D.\} and \{Hurtado Rua\}, \{Sandra M.\} and Gauthier, \{Susan A.\}",

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doi = "10.1002/acn3.70357",

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TY - JOUR

T1 - Quantifying the Impact of Ocrelizumab on Paramagnetic Rim Lesions in Multiple Sclerosis

AU - Markowitz, Kimberly H.

AU - Safi, Neha V.

AU - Pliska-Bloch, Iliana

AU - Kaunzner, Ulrike W.

AU - Luu, Ha

AU - Wang, Yi

AU - Nguyen, Thanh D.

AU - Hurtado Rua, Sandra M.

AU - Gauthier, Susan A.

PY - 2026/1/1

Y1 - 2026/1/1

N2 - Paramagnetic rim lesions (PRLs) are a subset of chronic active multiple sclerosis (MS) lesions marked by iron-laden microglia and macrophages. Ocrelizumab, a monoclonal antibody targeting CD20+ B cells, suppresses acute MS activity, but its effect on PRLs remains unclear. In a longitudinal study of 29 ocrelizumab-treated patients with at least one PRL on quantitative susceptibility mapping (QSM), 97 PRLs were identified. Before treatment, PRLs showed higher QSM values than non-PRLs (p = 0.001), indicating iron enrichment. After treatment, PRLs demonstrated a greater QSM reduction (p < 0.001), with an accelerated decline in susceptibility. These findings suggest ocrelizumab may attenuate iron-related inflammation in PRLs.

AB - Paramagnetic rim lesions (PRLs) are a subset of chronic active multiple sclerosis (MS) lesions marked by iron-laden microglia and macrophages. Ocrelizumab, a monoclonal antibody targeting CD20+ B cells, suppresses acute MS activity, but its effect on PRLs remains unclear. In a longitudinal study of 29 ocrelizumab-treated patients with at least one PRL on quantitative susceptibility mapping (QSM), 97 PRLs were identified. Before treatment, PRLs showed higher QSM values than non-PRLs (p = 0.001), indicating iron enrichment. After treatment, PRLs demonstrated a greater QSM reduction (p < 0.001), with an accelerated decline in susceptibility. These findings suggest ocrelizumab may attenuate iron-related inflammation in PRLs.

KW - multiple sclerosis

KW - ocrelizumab

KW - quantitative susceptibility mapping

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ER -

Quantifying the Impact of Ocrelizumab on Paramagnetic Rim Lesions in Multiple Sclerosis

Abstract

Keywords

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