Effectiveness of rituximab vs. ocrelizumab for the treatment of primary progressive multiple sclerosis: a real-world observational study

Real‐world evaluation of ocrelizumab in multiple sclerosis: A systematic review

“…Full text articles were available for 23 (44%) of the studies, while only conference abstracts were available for the remainder. Studies varied widely by geographical region; 33 reported real‐world outcomes in Europe, 7–39 seven in the United States, 40–46 two in the Middle East, 47,48 three in various geographical regions, 49–51 one in South America, 52 and six did not report the country in which the study was conducted 53–58 . The most frequently reported study populations included combined populations of RRMS, PPMS, and SPMS patients for which data were not stratified by type of MS ( n = 20).…”

“…Rituximab‐treated patients also had a higher mean number of prior DMTs compared to ocrelizumab patients (1.7 vs 1.3) in the study by Zanghi et al, which may account for the better relapse outcome with ocrelizumab, although the difference in number of prior DMTs was not statistically significant. Other studies have reported varying results comparing rituximab with ocrelizumab, with some reporting lack of non‐inferiority of rituximab versus ocrelizumab 60 and others reporting no significant difference in clinical outcomes 7 . As a result, comparative effectiveness conclusions are difficult to confidently draw from these studies or from real‐world studies in general.…”

“…Only six studies captured outcome data for both ocrelizumab and other treatments, which included rituximab, cladribine, fingolimod, dimethyl fumarate, natalizumab, and teriflunomide. [7][8][9]35,37,39 Two of the comparative studies reported significantly superior clinical outcomes in ocrelizumab-treated patients; Bigaut et al reported significantly fewer relapses, a greater reduction in ARR, fewer patients with new T2 lesions, and fewer patients with EDA when treated with ocrelizumab compared with fingolimod 8 and Zanghi et al reported significantly fewer relapses compared to rituximab-and cladribine-treated patients, decreased risk of ARR and MRI activity compared to cladribine-treated patients only, and similar rates of infection and adverse events across all treatment groups. 39 However, all of the comparative studies are relatively small and may be impacted by bias, particularly due to residual confounding.…”

“…Other studies have reported varying results comparing rituximab with ocrelizumab, with some reporting lack of non-inferiority of rituximab versus ocrelizumab 60 and others reporting no significant difference in clinical outcomes. 7 As a result, comparative effectiveness conclusions are difficult to confidently draw from these studies or from real-world studies in general. In order to best support patients and healthcare professionals in selecting an optimum therapeutic approach in RRMS and PPMS, further work is needed to generate evidence on the comparative effectiveness of the available therapies in the form of prospective comparative cohort studies with matched pairs.…”

Rituximab vs Ocrelizumab in Relapsing-Remitting Multiple Sclerosis

“…A head-to-head comparison of rituximab vs ocrelizumab has not previously been performed, apart from an analysis in primary progressive MS, which did not account for baseline group differences . Observational data have, however, been used to explore the effectiveness of both rituximab and ocrelizumab in comparison with other DMTs.…”