Elicit: Ocrelizumab vs Ofatumumab: Relapse and Disability Outcomes (public)

Ocrelizumab vs Ofatumumab: Relapse and Disability Outcomes (public)

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

n = 999

Papers screened using: Multiple Sclerosis Population, Target Medications, Real-World Data Source, Relevant Outcomes, Appropriate Study Design, MS-Focused Study, Adequate Study Type, Adult or Mixed Population

n = 999

Papers screened out

n = 959

Papers included for extraction

n = 40

Results

Characteristics of Included Studies

Study	Study Design	Registry Source	Population Size	Follow-up Duration	Full text retrieved
Zanghì et al., 2024	Retrospective cohort, multicenter, propensity-matched	Italian multiple sclerosis centers	396 (ocrelizumab: 216, ofatumumab: 180)	Mean 13.2 months	Yes
Zhu et al., 2022	Retrospective, multicenter, inverse probability of treatment weighting, registry	MSBase	1045	ocrelizumab: median 1.8 years; cladribine: 1.1 years; natalizumab: 3.6 years	Yes
Ghajarzadeh et al., 2025	Systematic review/meta-analysis	Multiple	No mention found	No mention found	No
Cunha et al., 2025	Retrospective cohort	No mention found	59	No mention found	No
Epstein et al., 2021	Retrospective chart review	No mention found	56	2 years	No
...	...	...	...	...	...

Annualized Relapse Rate

Study	Treatment	Annualized Relapse Rate (95% CI)	Study Population	Effect Size
Zanghì et al., 2024	ocrelizumab: 0.059; ofatumumab: 0.038	p=0.185	Relapsing multiple sclerosis	No significant difference
Zhu et al., 2022	ocrelizumab: 0.07; natalizumab: 0.11	ocrelizumab superior to cladribine, lower than natalizumab	Relapsing-remitting MS post-fingolimod	ocrelizumab superior to cladribine, lower than natalizumab
...	...	...	...	...

Confirmed Disability Progression

Study	Treatment	Confirmed Disability Progression Rate	Time to Progression	Statistical Significance
Zanghì et al., 2024	ocrelizumab/ofatumumab	0%	12 months	No difference
Zhu et al., 2022	ocrelizumab/natalizumab	no significant difference	No significant difference	...
...	...	...	...	...

Comparative Effectiveness

Direct registry-based comparisons of ocrelizumab and ofatumumab:

Zanghì et al., 2024 (large, multicenter, propensity-matched study): No significant difference in annualized relapse rate or confirmed disability progression between ocrelizumab and ofatumumab over 12 months.
The evidence base for ofatumumab is much smaller and less mature than for ocrelizumab, with limited sample sizes and shorter follow-up.

Registry Data Considerations

Several studies of ocrelizumab included large sample sizes and long follow-up.
The diversity of registry cohorts supports generalizability of findings for ocrelizumab, but the limited data for ofatumumab restricts conclusions about its comparative effectiveness in broader populations.