Ocrelizumab vs Ofatumumab: Relapse and Disability Outcomes

What is the annualized relapse rate and confirmed disability progression with ocrelizumab vs ofatumumab in registry data?

In registry studies, ocrelizumab and ofatumumab show comparable annualized relapse rates (0.059 vs 0.038, p = 0.185) and both achieve 0% confirmed disability progression at 12 months.

Abstract

Registry studies in multiple sclerosis report that ocrelizumab and ofatumumab yield comparable outcomes. In one large, multicenter, propensity‐matched study (Zanghì et al., 2024), the annualized relapse rate was 0.059 with ocrelizumab versus 0.038 with ofatumumab (p = 0.185), and both treatments showed 0% confirmed disability progression over 12 months. A small post–natalizumab cohort (Cunha et al., 2025) likewise observed no significant change in relapse rate or in Expanded Disability Status Scale scores between ocrelizumab and ofatumumab. Other registry reports of ocrelizumab document relapse rates ranging from 0.014 to 0.11, with very low rates of confirmed disability progression over follow-up intervals from 6 months to several years. These findings indicate that, based on available registry data, ocrelizumab and ofatumumab produce similar outcomes in annualized relapse rate and short-term disability progression among patients with multiple sclerosis.

Methods

We analyzed 40 sources from an initial pool of 999, using 8 screening criteria. Each paper was reviewed for 7 key aspects that mattered most to the research question. More on methods.

Papers identified with Elicit search

• Total: 999
• Papers screened out: 959
• Papers included for extraction: 40

Data extraction

The following data were extracted from each paper:

Annualized Relapse Rate (ARR)

• Baseline ARR: not specified
• On-treatment ARR: 0.059 (ocrelizumab), 0.038 (ofatumumab)
• Statistical significance: p = 0.185

Confirmed Disability Progression

• Method of measuring: 12-week confirmed disability progression
• Percentage of patients with progression: 0%
• Statistical significance: No significant differences reported

Results

Characteristics of Included Studies

• Study Design: Various designs, including retrospective cohort, multicenter, and observational.
• Registry Source: Studies from various registries including MSBase.
• Population Size: Ranging from less than 100 to over 1000 participants.
• Follow-up Duration: Ranges from less than a year to over 5 years.

Effects

Annualized Relapse Rate

• Zanghì et al., 2024: ocrelizumab: 0.059; ofatumumab: 0.038 (p=0.185)
• Zhu et al., 2022: ocrelizumab: 0.07 (0.04–0.13)
• Cunha et al., 2025: no significant change for ocrelizumab/ofatumumab

Confirmed Disability Progression

• Zanghì et al., 2024: 0% confirmed progression at 12 months.

Comparative Effectiveness

• Registry-based comparisons showed no significant difference in annualized relapse rate or confirmed disability progression between ocrelizumab and ofatumumab.

Conclusions

The evidence suggests comparable effectiveness between ocrelizumab and ofatumumab, with both therapies showing favorable outcomes regarding relapse rates and disability progression. The insights from this registry data can aid in long-term treatment strategies for patients with multiple sclerosis.