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Intriguingly however, very recent data on anti-CD20 B cell depleting agents might be showing some efficacy in progressive MS, although the effect of peripheral B cell depletion on PIRA cannot be interpreted as independent of its effect on silencing acute/adaptive inflammatory activity (Kappos et al., 2020)

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Secondary outcomes were categorised into: (i) blood or CSF biochemical redox markers such as GSH, GSSG, GSH/GSSG ratio, cysteine and 4-hydroxynonenal (4-HNE), (ii) brain biochemical imaging markers such as H-MRS-derived brain GSH, and (iii) imaging-based functional outcomes, inlcuding DAT binding assessed by DaTscan SPECT, which were interpreted as supportive mechanistic evidence rather than primary indicators of clinical efficacy