Ocrevus and Tysabri appear to work equally well to control relapsing MS
Danish study finds no difference in relapse rates or disease progression
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Ocrevus and Tysabri are equally effective in slowing the course of relapsing-remitting MS, according to a study from Denmark. (Photo from iStock)
- Ocrevus and Tysabri are equally effective in controlling relapsing-remitting multiple sclerosis, a Danish study finds.
- Both treatments prevent relapses, slow disability progression, and reduce brain lesions.
- Treatment choice may depend on lifestyle or safety profiles, not superior efficacy.
Two of the most effective treatments for relapsing-remitting multiple sclerosis (MS) — Ocrevus (ocrelizumab) and Tysabri (natalizumab) — are essentially matched in their ability to control the disease, a new nationwide study from Denmark suggests.
Researchers found no significant difference between the two therapies in preventing relapses, slowing disability progression, or reducing brain lesions.
“There is no difference in effectiveness,” researchers concluded, offering reassurance to patients that their choice between these two options may depend more on lifestyle preferences or safety profiles than on which medication is “stronger.”
The study, “A National Danish Effectiveness Study of Ocrelizumab Versus Natalizumab in Multiple Sclerosis,” was published in the European Journal of Neurology.
Balancing patient data for a fair comparison
MS is a chronic inflammatory autoimmune disorder in which the immune system mistakenly attacks and damages nerve cells in the brain and spinal cord. In relapsing-remitting MS, patients experience periods when symptoms suddenly worsen, called relapses, followed by periods of recovery. Both Ocrevus and Tysabri are approved as disease-modifying treatments to slow the course of MS.
The main goal of this nationwide study was to determine whether there are differences between Ocrevus and Tysabri in their ability to control relapsing-remitting MS.
Of the 926 people with relapsing-remitting MS included in the analysis, 542 were treated with Ocrevus and 384 with Tysabri. On average, patients in the Ocrevus group were older (40.5 vs. 36.9 years) and had been living with MS for a median of 2.8 years longer (6.1 vs. 3.3 years). They also scored higher on the Expanded Disability Status Scale, which indicates greater disability.
To ensure a fair comparison, the researchers used a statistical method called stabilized inverse probability of treatment weighting, which balances characteristics across groups. After balancing, the two groups were very similar, allowing for an accurate comparison. Follow-up time was slightly longer for patients on Ocrevus, with a median of 3.3 years compared with 2.8 years for those on Tysabri.
The annualized relapse rate, a measure of the average number of relapses per year, was the same in both groups at 0.071. Time to first progression independent of relapse activity, which measures disability progression unrelated to relapses, was similar between patients on Ocrevus and those on Tysabri, as was the number of such events (56 vs. 43).
New or enlarging T2 lesions and contrast-enhancing lesions indicate active disease, even if the patient does not notice new symptoms. The proportion of patients with significant lesion loads was similar between the two groups, and there was no meaningful difference in how long it took for the first sign of new inflammatory activity to appear on MRI scans.
Whether looking at physical symptoms or internal brain health, the two therapies performed with equal strength. Both treatments were equally effective in controlling relapses, slowing disability progression, and reducing signs of disease activity on MRI scans.
“To our knowledge, the present study is one of the first to use inverse probability of treatment weighting based on propensity scores to mitigate group differences that allows direct comparison between [Ocrevus] and [Tysabri],” the researchers wrote.
