Ocrevus (ocrelizumab), a second-generation anti-CD20 antibody, may be associated with a greater risk of infections. But it carries a lower risk of cancer and immune reactions than first-generation rituximab in people with multiple sclerosis (MS), according to a real-life study.
The higher incidence of infections linked with Ocrevus’ use may result from a potentially different or more extensive depletion of B-cells — the immune system target of anti-CD20 therapies — compared with rituximab, its researchers noted.
Future studies are needed to clarify this, and to better understand the safety differences between these therapies and other second-generation anti-CD20 antibodies, such as Novartis’ recently approved Kesimpta (ofatumumab).
B-cells, a type of immune cell that drives inflammation and immune attacks against myelin in MS, are a target of several MS therapies, including those based on antibodies against the CD20 protein found on the surface of B-cells.
While not approved for MS itself, rituximab was the first anti-CD20 antibody used to treat people with the disorder. It is marketed as Rituxan (by Biogen) in the U.S., Canada and Japan, and as MabThera (by Roche’s subsidiary Genentech) in Europe, with other brand names used elsewhere.
Second-generation anti-CD20 therapies were designed to have lower immunogenicity (the capacity to promote immune reactions against them), and greater effectiveness and tolerability over first-generation treatments.
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