Overview

• Researchers analyzed three major MS registries—MSBase, OFSEP, and the Danish MS Registry—comparing ocrelizumab with fingolimod, natalizumab, and alemtuzumab with at least six months of follow-up.
• In the fingolimod comparison, relapse rates favored ocrelizumab 0.06 vs 0.14, with fingolimod patients facing more than double the relapse risk (HR 2.26, 95% CI 1.98–2.58).
• Relapse rates were also lower with ocrelizumab than with natalizumab (0.07 vs 0.10) and alemtuzumab (0.12 vs 0.18), though the absolute differences were modest, such as roughly one fewer relapse per 33 patient-years versus natalizumab.
• No differences emerged between therapies in progression independent of relapse activity or in disability improvement, suggesting a ceiling for benefits from relapse suppression alone.
• Adverse-event reporting was inconsistent across registries; treatment persistence used as a tolerability proxy showed low discontinuation due to poor tolerability (6% for ocrelizumab, 8% for natalizumab) in this ECTRIMS 2025 presentation.