Elicit: Ocrelizumab vs Ofatumumab: Relapse and Disability Outcomes (public)
Ocrelizumab vs Ofatumumab: Relapse and Disability Outcomes
Research report
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.
Paper search
Using your research question “What is the annualized relapse rate and confirmed disability progression with ocrelizumab vs ofatumumab in registry data?”, we searched across over 126 million academic papers from the Semantic Scholar corpus. We retrieved the 999 papers most relevant to the query.
Screening
We screened in sources based on their abstracts that met these criteria:
- Multiple Sclerosis Population: Does this study include patients with multiple sclerosis (any subtype)?
- Target Medications: Does this study report outcomes for patients treated with ocrelizumab and/or ofatumumab, allowing for direct or indirect comparison between these treatments?
- Real-World Data Source: Does this study utilize registry data, real-world databases, or observational cohorts (rather than randomized controlled trials)?
- Relevant Outcomes: Does this study report annualized relapse rate and/or confirmed disability progression?
- Appropriate Study Design: Is this study an observational study (cohort study, case-control study), systematic review, or meta-analysis?
- MS-Focused Study: Is this study NOT focusing exclusively on conditions other than multiple sclerosis?
- Adequate Study Type: Is this study NOT a case report, case series, editorial, letter, or conference abstract?
- Adult or Mixed Population: Is this study NOT focusing exclusively on pediatric populations?
Data extraction
We asked a large language model to extract each data column below from each paper.
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 | Relapsing-remitting multiple sclerosis post-fingolimod | ocrelizumab superior to cladribine, lower than natalizumab | |
| Cunha et al., 2025 | ocrelizumab/ofatumumab: no significant change; rituximab: 0.08 (post-switch) | Post-natalizumab | No significant change for ocrelizumab/ofatumumab |
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 mention found | No mention found | No significant difference | |
| Cunha et al., 2025 | ocrelizumab/ofatumumab: no significant change; rituximab: EDSS increased | No mention found | No significant difference for ocrelizumab/ofatumumab |
Comparative Effectiveness
Direct registry-based comparisons of ocrelizumab and ofatumumab show no significant difference in annualized relapse rate or confirmed disability progression between the two drugs over 12 months.
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.
- Potential confounding and differences in patient populations may affect comparability across studies.