A 28-year-old woman presents with two episodes of optic neuritis separated by 3 months, and MRI brain shows periventricular white matter lesions. CSF shows oligoclonal bands and elevated IgG index. She is diagnosed with relapsing-remitting multiple sclerosis. Which disease-modifying therapy is classified as high-efficacy and is a monoclonal antibody targeting CD20?
- A Glatiramer acetate
- B Interferon beta-1a
- C Ocrelizumab ✓
- D Dimethyl fumarate
Correct answer: C. Ocrelizumab
Explanation
Ocrelizumab is a humanised anti-CD20 monoclonal antibody that depletes B cells and is classified as high-efficacy therapy for both relapsing-remitting and primary progressive MS (ORATORIO trial for PPMS; OPERA I/II for RRMS). It reduces annual relapse rate by approximately 46–47% compared to interferon beta-1a. Glatiramer acetate, interferon beta-1a, and dimethyl fumarate are moderate-efficacy first-line therapies with no anti-CD20 mechanism. Ofatumumab is another approved anti-CD20 for RRMS given subcutaneously.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.