Ocrelizumab and Rituximab for the Treatment of Multiple Sclerosis Patients: A Real-World Clinical Experience

Objective: The aim was to describe real clinical experience in using ocrelizumab (OCR) or rituximab (RTX) treatment for naive and previously treated multiple sclerosis (MS) patients. Looking for change in disability and clinical safety. Comparing the present EDSS status with other large studies world-wide was well thought-out. Methods: This work included 75 MS patients. Their characteristics including age, disease duration, age at onset, gender and type of MS were recorded as well as previous medications received before introducing OCR/RTX and any side effects. The EDSS was assessed. Results: The mean age of patients was 34.1±9.6 years, disease duration 6.2±5.1 years and age at onset 28±8.5 years. F:M was 1.3:1. 88% were relapsing-remitting (RRMS) and 12% secondary-progressive (SPMS). 37 received OCR and 38 RTX for treatment-naive (49.3%) or previously treated MS patiens (50.7%) cases for a duration of 3.18±1.38 years. The baseline EDSS (2.43±1.32) significantly decreased after treatment (1.69±2.03,p=0.014) especially in those receiving OCR (p=0.021). Relapse was present in 5.3%, side effects occurred in 8% of cases and only one deceased following RTX. Late-onset (LOMS)(n=2) had higher EDSS scores. SPMS patients had significantly higher EDSS before (p=0.003) and after (p<0.0001) receiving OCR/RTX compared to RRMS. EDSS significantly correlated with age (r=0.28,p=0.018) and could significantly discriminate both types (p<0.0001). Conclusion: Both ocrelizumab and rituximab were effective in halting the disability in MS cases with acceptable safety. The EDSS was remarkably related to the age being higher in those with LOMS.