Real-World Persistence with Ocrelizumab in Multiple Sclerosis Patients
Multiple sclerosis (MS) is a neurodegenerative autoimmune disease affecting approximately 2.9 million people globally in 2023. Ocrelizumab, a humanized monoclonal antibody targeting CD20+ B-cells, has been approved for treating RRMS and PPMS based on its safety and efficacy demonstrated in Phase III clinical trials (OPERA I and II and ORATORIO).
Real-world evidence is crucial for understanding the impact of ocrelizumab, as real-world populations are more diverse than those in randomized controlled trials. This systematic literature review (SLR) aimed to collate real-world data on ocrelizumab persistence in RRMS and PPMS patients.
Identified Studies:
- 30 studies met the PICOS criteria, with 14 being full-text articles.
- Studies were conducted across Europe, the US, the Middle East, and South America.
Ocrelizumab Discontinuation and Persistence:
- Discontinuation rates were 10% or lower in the majority of studies (80%).
- Seven studies reported 0% discontinuation rates over 6 to 18 months.
- High persistence rates were observed, with 12-month persistence ranging from 96.0% to 98.4% and 24-month persistence from 91.2% to 92.0%.
Reasons for Discontinuation:
- Adverse effects, lack of efficacy/clinical progression, and pregnancy/family planning were the most common reasons.
Comparative Studies:
- One study found no significant difference in discontinuation rates between ocrelizumab and rituximab, but a higher rate of discontinuation due to adverse events with ocrelizumab.
- Three additional studies reported lower discontinuation rates and higher adherence for ocrelizumab compared to other therapies.
Limitations:
- The review faced limitations due to the disparate nature of study designs, inclusion of conference abstracts with limited detail, and a small number of comparative studies.
Despite these limitations, the review underscores the low discontinuation rates and high persistence with ocrelizumab in real-world settings, aligning with clinical trial outcomes.