Comparative effectiveness of ofatumumab and ocrelizumab in relapsing multiple sclerosis: a target trial emulation using multinational registry data

• Autoři: ZHU Chao; VUKUSIC Sandra; KALINCIK Tomas; MATHEY Guillaume; KERMODE Allan G.; MAILLART Elisabeth; LECHNER-SCOTT Jeannette; LE PAGE Emanuelle; ROOS Izanne; CIRON Jonathan; KUBALA HAVRDOVA Eva; HORAKOVA Dana; DE SEZE Jerome; SKIBINA Olga; RUET Aurelie; YETKIN Mehmet Fatih; LABAUGE Pierre; HABEK Mario; KWIATKOWSKI Arnaud; BAGHBANIAN Seyed Mohammad; ZEPHIR Helene; MECA-LALLANA Jose E.; VALERO LOPEZ Gabriel; PAPEIX Caroline; GERLACH Oliver; DEFER Gilles; FABIS-PEDRINI Marzena; CARROLL William M.; LEBRUN-FRENAY Christine; HODGKINSON Suzanne; MOREAU Thibault; LAUREYS Guy; LAPLAUD David-Axel; PRAT Alexandre; BERGER Eric; LAPOINTE Emmanuelle; CLAVELOU Pierre; AMPAPA Radek; THOUVENOT Eric; STETKAROVA Ivana; HEINZLEF Olivier; ŠTOURAČ Pavel; PELLETIER Jean; FOSCHI Matteo; AL KHEDR Abdullatif; D'AMICO Emanuele; CASEZ Olivier; ALROUGHANI Raed; BOURRE Bertrand; BRECL JAKOB Gregor; CREANGE Alain; OZAKBAS Serkan; DAVID Thomas; JOHN Nevin; MAGY Laurent; CAMDESSANCHE Jean-Philippe; MOULIN Solene; DOGHRI Ines; SAROV RIVIERE Mariana; HANKIEWICZ Karolina; POTTIER Corinne; MANCHON Eric; ABOAB Jennifer; TCHIKVILADZE Maia; NIFLE Chantal; MERLO Daniel; MONIF Mastura; ZHOU Zhen; FOONG Yi Chao; JOKUBAITIS Vilija; VAN DER WALT Anneke; BUTZKUEVEN Helmut
• Rok publikování: 2026
• Druh: Recenzovaný odborný článek
• Časopis / Zdroj: JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
• Fakulta / Pracoviště MU: Lékařská fakulta
• www: https://jnnp.bmj.com/content/early/2026/08/13/jnnp-2026-339059
• Doi: https://doi.org/10.1136/jnnp-2026-339059
• Klíčová slova: MULTIPLE SCLEROSIS
• Popis: Background Ofatumumab and ocrelizumab are widely used high-efficacy anti-CD20 therapies for relapsing-remitting multiple sclerosis (RRMS), but direct comparative evidence remains limited. We aimed to compare their effectiveness in routine clinical practice.Methods We conducted an observational cohort study emulating a target trial using data from the MSBase and Observatoire Fran & ccedil;ais de la Scl & eacute;rose en Plaques registries (January 2021 to December 2024). Adults with RRMS initiating ofatumumab or ocrelizumab were included. Patients were matched 1:1 using propensity scores. Primary outcomes were annualised relapse rate (ARR) and time to first relapse. Secondary outcomes included time to confirmed disability progression (CDP), progression independent of relapse activity (PIRA), confirmed disability improvement (CDI), MRI activity and treatment discontinuation. Negative binomial and Cox regression models were applied.Results A total of 5288 patients were matched with a median follow-up of 1.2 years for ofatumumab and 1.4 years for ocrelizumab. ARR was 0.07 (95% CI 0.05 to 0.08) with ofatumumab and 0.04 (0.03 to 0.05) with ocrelizumab, corresponding to an ARR ratio of 1.75 (1.43 to 2.13). Ofatumumab was associated with a lower risk of CDP (HR 0.66; 0.49 to 0.87) and PIRA (0.53; 0.39 to 0.73), but a lower probability of CDI (0.76; 0.60 to 0.96). No significant differences were observed in MRI activity or treatment discontinuation.Conclusions Both therapies were highly effective in a large cohort of patients with RRMS, with very low relapse or CDP rates. Ofatumumab was associated with slightly greater disability control, while ocrelizumab more effectively suppressed relapses. These differences were modest, and their clinical relevance requires further evidence and should be interpreted with caution.