Multiple sclerosis (Houndmills, Basingstoke, England) · 2026
Comparative effectiveness of rituximab versus ocrelizumab in relapsing multiple sclerosis on clinical relapses and radiological outcomes in British Columbia, Canada.
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Chu Nathan Y, Roberts Jodie I, Hunt David J, Kuipers Donna, Morkous Jomana, West Kyra, Uy Christopher E, Alhalabi Mohammad, Sayao Ana-Luiza, Carruthers Robert L, Traboulsee Anthony, Devonshire Virginia, Roos Izanne, Kalincik Tomas, Schabas Alice J
Аннотация
BACKGROUND: Recent research has suggested that rituximab is not non-inferior to ocrelizumab in the treatment of relapsing multiple sclerosis (RMS). We compared the effectiveness of rituximab versus ocrelizumab in RMS.
METHODS: Individuals with RMS treated with rituximab or ocrelizumab with ⩾12 months of clinical follow-up and/or post-rebaseline magnetic resonance imaging (MRI) data were propensity-scored matched 1:1 and included.
OBJECTIVES: Primary outcomes were annualized relapse rate (ARR), ARR ratio and cumulative hazard of relapses. The secondary outcome was the proportion of each group demonstrating post-rebaseline radiological activity.
RESULTS: In total, 538 individuals were included in the primary (clinical) outcome analysis and 350 individuals were included in the secondary (radiologic) outcome analysis. Over a median 2-year follow-up, very low ARR was observed in both groups (rituximab: 0.05 (95% CI: 0.03-0.08) versus ocrelizumab: 0.03 (95% CI: 0.02-0.05)). The adjusted ARR ratio for rituximab compared with ocrelizumab was elevated at 1.76 (95% CI: 0.70-4.59), and the adjusted cumulative hazard of relapses was also elevated for rituximab-treated individuals (HR = 2.17 (95% CI: 0.91-5.1)).
CONCLUSION: Although our results suggest that rituximab may be inferior to ocrelizumab for relapse suppression, the rarity of relapses underpowered comparisons, and no definitive conclusions could be drawn.
METHODS: Individuals with RMS treated with rituximab or ocrelizumab with ⩾12 months of clinical follow-up and/or post-rebaseline magnetic resonance imaging (MRI) data were propensity-scored matched 1:1 and included.
OBJECTIVES: Primary outcomes were annualized relapse rate (ARR), ARR ratio and cumulative hazard of relapses. The secondary outcome was the proportion of each group demonstrating post-rebaseline radiological activity.
RESULTS: In total, 538 individuals were included in the primary (clinical) outcome analysis and 350 individuals were included in the secondary (radiologic) outcome analysis. Over a median 2-year follow-up, very low ARR was observed in both groups (rituximab: 0.05 (95% CI: 0.03-0.08) versus ocrelizumab: 0.03 (95% CI: 0.02-0.05)). The adjusted ARR ratio for rituximab compared with ocrelizumab was elevated at 1.76 (95% CI: 0.70-4.59), and the adjusted cumulative hazard of relapses was also elevated for rituximab-treated individuals (HR = 2.17 (95% CI: 0.91-5.1)).
CONCLUSION: Although our results suggest that rituximab may be inferior to ocrelizumab for relapse suppression, the rarity of relapses underpowered comparisons, and no definitive conclusions could be drawn.