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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Multiple Sclerosis and Neuroimmunology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1530438

Ocrelizumab-Induced Colitis -Critical Review and Case Series from a Romanian Cohort of MS Patients

Provisionally accepted
Ileana Maria Vodă Ileana Maria Vodă 1Vlad Eugen Tiu Vlad Eugen Tiu 2,3*Luiza Răuță Luiza Răuță 1Paul Ciucur Paul Ciucur 1Andreea Ioana Mușuroi Andreea Ioana Mușuroi 1Alina Flavia Tomescu Alina Flavia Tomescu 1,4Nicoleta Laura Humă Nicoleta Laura Humă 1Florin Dobrițoiu Florin Dobrițoiu 1,5Elena Terecoasă Elena Terecoasă 1,3Lucian Negreanu Lucian Negreanu 1,4Cristina Tiu Cristina Tiu 1,3
  • 1 Bucharest University Emergency Hospital, Bucharest, Romania
  • 2 Elias University Emergency Hospital, Bucharest, Romania
  • 3 Department of Neurology, Carol Davila University of Medicine and Pharmacy, Bucharest, Bucharest, Romania
  • 4 Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
  • 5 Pathoteam Diagnostic Laboratory, Bucharest, Romania

The final, formatted version of the article will be published soon.

    Background: Widespread use of ocrelizumab, an anti-CD20 monoclonal antibody, for treating patients with multiple sclerosis (MS), has led to an increase in reported adverse events following real-world observation. Among these, drug-induced colitis is a rare, but severe side effect, prompting a recent FDA statement regarding this safety concern. Objectives: We analyzed a cohort of ocrelizumab treated patients in our MS center to evaluate the incidence of drug-induced colitis. Methods: We present a critical review of the available literature on diagnosis and management of anti-CD20 induced colitis and display a case series of 3 suspected patients in our cohort. Results: Two patients met the full criteria for ocrelizumab-induced colitis, while a third partially met the criteria. Following symptomatic treatment and discontinuation of ocrelizumab, the patients showed favorable outcomes. Conclusion: Ocrelizumab induced colitis is a rare, but severe adverse event. Its incidence may be higher than expected, reaching 1,95% in our cohort of MS patients. Further reporting of such cases is essential to broaden our understanding of this side effect.

    Keywords: Multiple Sclerosis, drug induced colitis, Colitis, Ocrelizumab, review, CD-20

    Received: 18 Nov 2024; Accepted: 21 Jan 2025.

    Copyright: © 2025 Vodă, Tiu, Răuță, Ciucur, Mușuroi, Tomescu, Humă, Dobrițoiu, Terecoasă, Negreanu and Tiu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Vlad Eugen Tiu, Elias University Emergency Hospital, Bucharest, Romania

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.