Elicit: Ocrelizumab vs Ofatumumab: Relapse and Disability Outcomes (public)
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.
Screening Criteria
- Multiple Sclerosis Population: Inclusion of patients with MS.
- Target Medications: Outcomes for ocrelizumab and/or ofatumumab.
- Real-World Data Source: Registry data, observational cohorts.
- Relevant Outcomes: Annualized relapse rate and/or confirmed disability progression.
- Appropriate Study Design: Observational study, systematic review, or meta-analysis.
- MS-Focused Study: Studies not focusing exclusively on other conditions.
- Adequate Study Type: Not a case report, case series, etc.
- Adult or Mixed Population: Exclude exclusively pediatric studies.
Results
Characteristics of Included Studies
| Study | Study Design | Registry Source | Population Size | Follow-up Duration |
|---|---|---|---|---|
| Zanghì et al., 2024 | Retrospective, multicenter, propensity-matched | Italian MS centers | 396 (ocrelizumab: 216, ofatumumab: 180) | Mean 13.2 months |
| Zhu et al., 2022 | Retrospective, multicenter, inverse probability of treatment weighting | MSBase | 1045 | ocrelizumab: median 1.8 years |
| Cunha et al., 2025 | Retrospective cohort | Not mentioned | 59 | Not mentioned |
| Epstein et al., 2021 | Retrospective chart review | Not mentioned | 56 | 2 years |
| Ellwardt et al., 2020 | Retrospective, multicenter, observational | 3 neurology centers | 210 | Median 200 days (range 30–1674) |
Annualized Relapse Rate Findings
- Annualized Relapse Rate (ARR):
- 0.059 (ocrelizumab) vs 0.038 (ofatumumab), p=0.185 (Zanghì et al., 2024)
- Ocrelizumab shown as superior to fingolimod and cladribine in several studies.
Confirmed Disability Progression Findings
- Disability Progression: 0% confirmed disability progression at 12 months for both drugs in the Zanghì study.
Summary
Overall, ocrelizumab and ofatumumab appear equally effective concerning annualized relapse rates and confirmed disability progression at observed follow-up intervals. A notable limitation is that the evidence base for ofatumumab is limited compared to ocrelizumab, necessitating further research.
References
- Zanghì et al., 2024. Ocrelizumab and ofatumumab comparison: an Italian real-world propensity score matched study. Journal of Neurology.
- Zhu et al., 2022. Intravenous ofatumumab treatment of multiple sclerosis and related disorders: An observational study. Multiple Sclerosis and Related Disorders.
- Cunha et al., 2025. Long-term evaluation of ocrelizumab in patients with multiple sclerosis. Multiple Sclerosis and Related Disorders.