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.

Data extraction

We asked a large language model to extract each data column below from each paper.

• Study Design:

  • Identify and extract the specific type of study design.

• Patient Population Characteristics:

  • Total number of patients
  • Mean/median age
  • Gender distribution
  • Multiple sclerosis type
  • Mean disease duration
  • Baseline Expanded Disability Status Scale (EDSS) score
  • Treatment-naive status vs. previous treatment history

• Interventions Compared:

  • Drug names
  • Dosage (if specified)
  • Treatment duration
  • Number of patients in each treatment group

• Annualized Relapse Rate (ARR):

  • Baseline ARR
  • On-treatment ARR
  • Confidence intervals
  • Statistical significance of differences between groups

• Disability Progression:

  • Method of measuring disability progression
  • Percentage of patients with disability progression
  • Changes in EDSS score
  • Statistical significance of differences between groups

Results

Characteristics of Included Studies

Annualized Relapse Rate Results

Confirmed Disability Progression Results

Registry Data Considerations

• Several studies of ocrelizumab included large sample sizes and long follow-up.
• The evidence base for ofatumumab is limited, with only a few small, short-term studies.