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

Ofatumumab and ocrelizumab are widely used high-efficacy anti-CD20 therapies for relapsing multiple sclerosis, but direct comparative evidence is limited. Prior observational studies have generally reported similar effectiveness between the two treatments, with low relapse rates and no clear differences in disability outcomes.

In this large real-world cohort, both therapies showed high effectiveness, but small differences were observed: ocrelizumab was associated with lower relapse rates, whereas ofatumumab was associated with a lower risk of disability progression. Absolute differences were significant but very small. Findings were consistent across sensitivity analyses.

Our findings highlight the clinical equivalence of ocrelizumab and ofatumumab. However, the small but significant divergence between relapse and disability outcomes between these drugs could be due to differences in administration frequency or drug availability,...