Ocrelizumab Demonstrates Superior Control of Multiple Sclerosis Relapses in Multi-Registry Study

A large multi-registry study shows that ocrelizumab provides better control of MS relapses compared to other high-efficacy therapies, highlighting its potential for managing disease activity in multiple sclerosis.
A comprehensive study presented at the 41st Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS 2025) reveals that ocrelizumab, a monoclonal antibody targeting CD20+ B cells, offers more effective relapse control in multiple sclerosis (MS) compared to other high-efficacy therapies like fingolimod, natalizumab, and alemtuzumab.
This research utilized real-world data from three large MS registries: MSBase, OFSEP, and the Danish MS Registry. The analysis compared MS patients treated with ocrelizumab against cohorts on fingolimod (2,600 vs. 4,103), natalizumab (3,197 vs. 2,437), and alemtuzumab (2,960 vs. 644), all with at least six months of treatment and follow-up.
Results showed that relapse rates were significantly lower in the ocrelizumab group. Specifically, patients on fingolimod experienced a relapse rate of 0.14, whereas those on ocrelizumab had a rate of just 0.06, translating into more than twice the risk of relapse with fingolimod (HR 2.26, 95% CI 1.98–2.58; p<0.001). Additionally, ocrelizumab reduced the likelihood of relapse-related worsening and was associated with a marginal, though statistically significant, difference in comparison with natalizumab and alemtuzumab.
The study also evaluated treatment tolerability through persistence rates, noting that only 8% of natalizumab and 6% of ocrelizumab patients discontinued treatment due to poor tolerability, indicating good tolerability for both therapies.
While ocrelizumab effectively decreased relapses, it did not show significant advantages in slowing disease progression or enhancing disability improvement compared to other therapies. Dr. Izanne Roos, the study's lead author, emphasized that although the reductions in relapse rates are meaningful, they are modest and most pronounced among patients with recent disease activity or prior treatment failure.
The findings underscore the importance of targeting relapse-independent progression in MS, as current therapies managing relapses alone may not fully address long-term disability. Continued research is needed to develop treatments that can more effectively modify disease progression beyond relapse control.
Source: medicalxpress.com
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