Comparing the efficacy and safety of extended vs standard dosing of ocrelizumab in MS: A systemic review and meta-analysis.

INTRODUCTION

Multiple Sclerosis (MS) is a challenging autoimmune disease that disrupts the central nervous system, leading to a range of symptoms. Ocrelizumab, a treatment commonly used for MS, targets B cells to help manage the disease. While the standard-interval dosing (SID) is effective, the COVID-19 pandemic raised concerns about safety, particularly around immune responses. This prompted interest in extended-interval dosing (EID), which spaces out treatments more. Our study aims to compare how well EID works against SID and if it's safer for patients.

METHODS

We followed strict guidelines to review the research on EID and SID in MS patients. Using databases like PubMed and Scopus, we looked for studies up to July 2024. We included clinical trials and cohort studies that directly compared these dosing strategies. A team of reviewers collected data, assessed the quality of the studies, and performed statistical analysis to find any differences in effectiveness and safety.

RESULTS

Our analysis included 11 studies involving over 2,500 patients. We found that EID and SID were similarly effective in controlling disease activity (no significant difference in NEDA). However, patients on EID experienced fewer side effects, with significantly fewer adverse events compared to those on SID.

CONCLUSION

EID appears to be just as effective as SID in managing MS, but with the added benefit of reducing side effects. This makes EID a promising alternative for long-term treatment, offering patients a lighter treatment burden while maintaining disease control. More research is needed to explore its long-term impact.