An update on the evaluation of treatment switching criteria in multiple sclerosis Kevin Bigaut, Judicaelle Didierjean, Jerome de Seze Expert Review of Neurotherapeutics, 2025 INTRODUCTION Multiple sclerosis (MS) is a complex disorder driven by both inflammatory and neurodegenerative processes. While disease-modifying therapies (DMTs) have significantly improved prognosis, robust treatment switching criteria remain essential to balance efficacy and safety over the disease course. AREAS COVERED This review examines historical and current criteria for escalating DMTs from moderate- to high-efficacy therapies (HET). The authors summarize emerging clinical, imaging, and biological markers that inform decision-making and explore strategies for de-escalation, including DMT discontinuation and innovative approaches such as exit and bridge therapies. EXPERT OPINION Recent advances in MS management emphasize earlier initiation of HET and more stringent switching criteria. Although innovative monitoring tools - including clinical evaluations, imaging, biological markers, and patient-reported outcomes (PROs) - enhance disease assessment, they require further validation, standardization, and broader accessibility. Similarly, de-escalation criteria need additional research to optimize patient selection.
Unveiling the Clinical and Imaging Signatures of Intravascular Lymphoma of the Central Nervous System: A Multicentric Cohort Study Elodie Berthet, Antoine Guillonnet, Caroline Houillier, Renata Ursu, Carole Soussain, et al. Annals of Neurology, 2025 ObjectiveIntravascular lymphoma is a rare subtype of Bâcell lymphoma characterized by a clonal proliferation restricted to the lumen of small vessels. Over 50% of patients exhibit central nervous system (CNS) involvement, but diagnosis is often delayed due to the lack of distinctive features. We aimed to identify key phenotypic features for early diagnosis of intravascular lymphoma with CNS involvement through an inâdepth cohort study.MethodsWe built up a multicenter retrospective cohort of 17 patients recruited in collaboration with the French Expert Network for OculoâCerebral Lymphomas (LOC network), and retrospectively analyzed data from medical records.ResultsIn this cohort, 15 of 17 (88%) patients developed focal neurological episodes, often fluctuating and/or recurrent, with a sudden onset in 68% of episodes, suggesting a vascular origin. Rapid cognitive deterioration occurred in 15 of 17 (88%) patients, psychiatric manifestations in 8 of 17 (47%), and âB signsâ in 14 of 17 (82%). Brain MRI showed polymorphic FLAIR hyperintensities in 14 of 16 (87%) patients, and DWIâpositive lesions in 13 of 16 (81%) of patients, which accumulated over time and had unusual characteristics for ischemic lesions (progressive growth, persistent DWIâhyperintensity over 1 month, surrounded by a wider FLAIR hyperintensity). Earlyâonset inflammatory syndrome, and elevated lactate dehydrogenase (LDH) levels were observed in over 90% of cases. Mild and inconsistent meningitis contrasted with a nearlyâconstant hyperproteinorachia. An increased interleukin 10/6 ratio over 0,7 was found in 4 of 7 (57%) patients, and skin biopsy led to a pathological diagnosis in 3 of 6 (50%) patients.InterpretationThe results of this study highlight âred flagsâ that could help accelerate the diagnosis of intravascular lymphoma involving the CNS. ANN NEUROL 2024
Troubles de la marche dâinstallation progressive chez un homme de 37 ans D Ricard, L Lamarque, K Bigaut, A Fattori, F Sellal Pratique Neurologique-FMC , 2026 2026
High risk of hypoxemic COVID-19 pneumonia in myasthenia gravis patients with type I IFN autoantibodies A Gervais, A Marchal, A Maillard, T Le Voyer, J Rosain, Q Philipot, ... Medrxiv , 2026 2026
A multidimensional analysis of neuropsychiatric lupus: clinical, biological and imaging insights from systematic evidence K Matmat, H Jamann, A Maazouzi, K Bigaut, M Maitre, J De Seze, ... Frontiers in Immunology 17, 1768131 , 2026 2026
Complement inhibition for acute neuromyelitis optica spectrum disorder attacks: Insights from an international case series PS Rommer, W Jiang, JP Nolte, T Mikami, J De Seze, P SĂĄnchez, A Harel, ... Neurology: Neuroimmunology & Neuroinflammation 13 (2), e200548 , 2026 2026 Citations: 2
Evaluating MRI-Confirmed Relapses as a Novel Primary Endpoint in Multiple Sclerosis Trials A Gavoille, S Demuth, M Nourredine, I Faddeenkov, F Rollot, R Casey, ... medRxiv, 2025.10. 10.25337738 , 2025 2025 Citations: 1
Complement inhibition in acute NMOSD attacks: Insights from a multicentric case series P Rommer, W Jiang, J Nolte, T Mikami, J De Seze, P Sanchez-Lopez, ... MULTIPLE SCLEROSIS JOURNAL 31 (3), 145-146 , 2025 2025
Advancing medical training with augmented reality and haptic feedback simulator: outcomes of a randomized controlled trial on lumbar puncture R Felten, K Bigaut, T Wirth, L Kremer, L Gauer, C Arnold, I Ollivier, J Godet, ... BMC Medical Education 25 (1), 1231 , 2025 2025 Citations: 7
An update on the evaluation of treatment switching criteria in multiple sclerosis K Bigaut, J Didierjean, J de Seze Expert Review of Neurotherapeutics 25 (8), 911-928 , 2025 2025 Citations: 1
Vaincre la neurophobie par le jeu? Le Neuromancien, un outil pour lâapprentissage du raisonnement neurologique K Bigaut, T Wirth Revue Neurologique 181, S116 , 2025 2025
SUNCT onset following ophthalmic-distribution zoster: Description of a case and review of the literature A Storck, M Fleury, G Tacchi, G Maffon, L Kremer, K Bigaut Revue neurologique 181 (3), 232-235 , 2025 2025
Unveiling the clinical and imaging signatures of intravascular lymphoma of the central nervous system: A multicentric cohort study E Berthet, A Guillonnet, C Houillier, R Ursu, C Soussain, M Touat, ... Annals of Neurology 97 (3), 435-448 , 2025 2025 Citations: 9
European experience of cladribine tablets in elderly patients with multiple sclerosis: Could it be the last treatment? J de Seze, C Zecca, G Castelnovo, X Ayrignac, P Vermersch, C Gobbi, ... Multiple Sclerosis JournalâExperimental, Translational and Clinical 11 (1 ⊠, 2025 2025 Citations: 7
MOST CITED SCHOLAR PUBLICATIONS
Clinical characteristics and outcomes in patients with coronavirus disease 2019 and multiple sclerosis C Louapre, N Collongues, B Stankoff, C Giannesini, C Papeix, C Bensa, ... JAMA neurology 77 (9), 1079-1088 , 2020 2020 Citations: 522
DMTs and Covidâ19 severity in MS: a pooled analysis from Italy and France MP Sormani, M Salvetti, P Labauge, I Schiavetti, H Zephir, L Carmisciano, ... Annals of Clinical and Translational Neurology 8 (8), 1738-1744 , 2021 2021 Citations: 132
Kappa free light chain biomarkers are efficient for the diagnosis of multiple sclerosis: a large multicenter cohort study M Levraut, S Laurent-Chabalier, X Ayrignac, K Bigaut, M Rival, S Squalli, ... Neurology: Neuroimmunology & Neuroinflammation 10 (1), e200049 , 2022 2022 Citations: 77
A rise in cases of nitrous oxide abuse: neurological complications and biological findings M Einsiedler, P Voulleminot, S Demuth, P Kalaaji, T Bogdan, L Gauer, ... Journal of Neurology 269 (2), 577-582 , 2022 2022 Citations: 49
Pregnancy and multiple sclerosis: 2022 recommendations from the French multiple sclerosis society S Vukusic, C Carra-Dalliere, J Ciron, E Maillart, L Michel, E Leray, ... Multiple Sclerosis Journal 29 (1), 11-36 , 2023 2023 Citations: 48
Prognostic indicators and outcomes of hospitalised COVID-19 patients with neurological disease: An individual patient data meta-analysis B Singh, S Lant, S Cividini, JWS Cattrall, LC Goodwin, L Benjamin, ... PLoS One 17 (6), e0263595 , 2022 2022 Citations: 47
High-efficacy therapy discontinuation vs continuation in patients 50 years and older with nonactive MS G Jouvenot, G Courbon, M Lefort, F Rollot, R Casey, E Le Page, L Michel, ... JAMA neurology 81 (5), 490-498 , 2024 2024 Citations: 44
Ocrelizumab for the treatment of multiple sclerosis K Bigaut, J De Seze, N Collongues Expert review of neurotherapeutics 19 (2), 97-108 , 2019 2019 Citations: 43
Impact of disease-modifying treatments of multiple sclerosis on antiâSARS-CoV-2 antibodies: an observational study K Bigaut, L Kremer, T Fabacher, L Lanotte, MC Fleury, N Collongues, ... Neurology: Neuroimmunology & Neuroinflammation 8 (5), e1055 , 2021 2021 Citations: 41
Pregnancy and neuromyelitis optica spectrum disorders: 2022 recommendations from the French Multiple Sclerosis Society S Vukusic, R Marignier, J Ciron, B Bourre, M Cohen, R Deschamps, ... Multiple Sclerosis Journal 29 (1), 37-51 , 2023 2023 Citations: 36
Impact of disease-modifying treatments on humoral response after COVID-19 vaccination: a mirror of the response after SARS-CoV-2 infection K Bigaut, L Kremer, M Fleury, L Lanotte, N Collongues, J de SĂšze Revue neurologique 177 (10), 1237-1240 , 2021 2021 Citations: 36
How to switch disease-modifying treatments in multiple sclerosis: Guidelines from the French Multiple Sclerosis Society (SFSEP) K Bigaut, M Cohen, F Durand-Dubief, E Maillart, E Planque, H Zephir, ... Multiple sclerosis and related disorders 53, 103076 , 2021 2021 Citations: 34
Severe early-onset impulsive compulsive behavior and psychosis in PLA2G6-related juvenile Parkinson's disease T Wirth, S Weibel, S Montaut, K Bigaut, G Rudolf, J Chelly, C Tranchant, ... Parkinsonism & Related Disorders 41, 127-129 , 2017 2017 Citations: 33
The translatability of multiple sclerosis animal models for biomarkers discovery and their clinical use D Birmpili, I Charmarke Askar, K Bigaut, D Bagnard International journal of molecular sciences 23 (19), 11532 , 2022 2022 Citations: 31
Ocrelizumab versus fingolimod after natalizumab cessation in multiple sclerosis: an observational study K Bigaut, L Kremer, T Fabacher, G Ahle, M Goudot, M Fleury, C Gaultier, ... Journal of Neurology 269 (6), 3295-3300 , 2022 2022 Citations: 30
An autophagy-targeting peptide to treat chronic inflammatory demyelinating polyneuropathies S Brun, N Schall, SR Bonam, K Bigaut, AG Mensah-Nyagan, J de SĂšze, ... Journal of Autoimmunity 92, 114-125 , 2018 2018 Citations: 30
Acute clinical events identified as relapses with stable magnetic resonance imaging in multiple sclerosis A Gavoille, F Rollot, R Casey, A Kerbrat, E Le Page, K Bigaut, G Mathey, ... JAMA neurology 81 (8), 814-823 , 2024 2024 Citations: 26
Unravelling the etiology of sporadic late-onset cerebellar ataxia in a cohort of 205 patients: a prospective study T Bogdan, T Wirth, A Iosif, A Schalk, S Montaut, C Bonnard, G Carre, ... Journal of Neurology 269 (12), 6354-6365 , 2022 2022 Citations: 26
Post-vaccine COVID-19 in patients with multiple sclerosis or neuromyelitis optica E Januel, J De Seze, P Vermersch, E Maillart, B Bourre, J Pique, ... Multiple Sclerosis Journal 28 (7), 1155-1159 , 2022 2022 Citations: 25
