Ocrelizumab (Ocrevus) for people with relapsing-remitting multiple sclerosis

In 2018, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into the advantages and disadvantages of Ocrelizumab (trade name: Ocrevus) compared with the standard treatments for people with relapsing-remitting multiple sclerosis (RRMS).

For this assessment, the manufacturer provided two studies involving a total of 1,377 people. Half of the participants had treatment with interferon beta, while the rest used ocrelizumab. The patients had an average of 2 flare-ups during the two years prior to the beginning of the study. The following results were found after about three years and eight months:

What are the advantages of ocrelizumab?

  • Relapses: The studies show that ocrelizumab has an advantage here. People under the age of 40 had less than half the number of relapses experienced by people who used interferon beta. This advantage was smaller in older people.
  • Serious side effects: Here too, the studies show an advantage for people under the age of 40: About 4 out of 100 people who took ocrelizumab had serious side effects, compared with 7 out of 100 people who used interferon beta. No difference was found in patients over the age of 40.
  • There was also an advantage in terms of termination of treatment due to side effects. About 4 out of 100 people who used ocrelizumab stopped their treatment, compared to about 7 out of 100 people who took interferon beta.
  • Influenza-like symptoms, and skin reactions at the site of injection: Interferon beta is self-injected by the patients at shorter intervals. As a result, these problems occur more frequently in people who use interferon beta than in people who use ocrelizumab.

What are the disadvantages of ocrelizumab?

  • Side effects: The studies show that ocrelizumab has a disadvantage here. During the infusion with ocrelizumab, about 33 out of 100 people experienced side effects caused by the infusion, such as headaches, fever, nausea or shortness of breath. This was the case in about 9 out of 100 people who had the treatment with interferon beta.

No difference

  • Life expectancy: There was no difference in terms of life expectancy. During the course of the study, one person passed away.
  • There was also no difference between the treatments in terms of the following aspects:
    • Exhaustion
    • General health
    • Infections and parasitic diseases
    • Depression

What remains unanswered?

  • Effects of the disease and quality of life: Ocrelizumab had an advantage over interferon beta in terms of the effect on disease-related physical limitations. But the difference was too small to tell whether the improvement is noticeable to patients.
Labels: G35, Ocrelizumab, Ocrevus