DOI: 10.4103/ijhas.ijhas_20_25 ISSN: 2278-4292

Effectiveness and adverse effects associated with ocrelizumab in relapsing-remitting multiple sclerosis: A comprehensive meta-analysis

Mazen A. Basheikh, Adnan A. Badahdah
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PURPOSE:

This meta-analysis synthesized the evidence from randomized controlled trials and real-world data investigating the efficacy and safety of ocrelizumab in relapsing-remitting multiple sclerosis (RRMS), at various follow-up points.

METHODS:

A systematic search was performed on PubMed, Web of Science, and Scopus from inception to October 2024 using the search strategy: “Multiple sclerosis” AND “Relapsing remitting” AND “Ocrelizumab”. The mean difference (MD) was calculated for continuous variables, and the odds ratio (OR) was used for dichotomous variables, comparing baseline values and posttreatment outcomes. Meta-analysis was conducted using Review Manager version 5.4 software.

RESULTS:

Of 568 articles identified in the database search, 17 articles were included in this review. Ocrelizumab significantly decreased the annualized relapse rate (ARR: MD = −0.6, 95% CI: −0.73, −0.47; P < 0.00001) and reduced the risk of ARR (OR = 0.21, 95%CI: 0.1, 0.41; P < 0.00001). Sensitivity analysis (leave-one-out method) and subgroup analysis by measurement did not resolve heterogeneity. Ocrelizumab also reduced the number (MD = −0.26, 95% CI: −0.33, −0.2; P < 0.00001) and risk (OR = 0.11, 95%CI: 0.07, 0.16; P < 0.00001) of T1-weighted (T1) gadolinium (T1-Gd) enhancing lesions. In addition, ocrelizumab reduced the number of T2 lesions (MD = −1.23, 95% CI: −2.14, −0.32; P = 0.008). On the other hand, no significant effect was observed on the Expanded Disability Status Scale ( P = 0.58).

CONCLUSION:

This systematic review and meta-analysis of clinical and radiological outcomes demonstrated the effectiveness of ocrelizumab in reducing relapses and lesion counts associated with RRMS, while stopping disability progression. The associated side effects were minimal, with a low incidence of serious adverse events. Thus, ocrelizumab is an effective and well-tolerated treatment option for RRMS patients.

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