{"id":122,"date":"2025-09-08T23:00:00","date_gmt":"2025-09-08T23:00:00","guid":{"rendered":"https:\/\/wickedsister.evit.com.au\/index.php\/2025\/09\/08\/safety-of-rituximab-versus-ocrelizumab\/"},"modified":"2025-09-08T23:00:00","modified_gmt":"2025-09-08T23:00:00","slug":"safety-of-rituximab-versus-ocrelizumab","status":"publish","type":"post","link":"https:\/\/wickedsister.evit.com.au\/index.php\/2025\/09\/08\/safety-of-rituximab-versus-ocrelizumab\/","title":{"rendered":"Safety of Rituximab versus Ocrelizumab"},"content":{"rendered":"
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A recent US multi-center study involving over 1,400 patients with multiple sclerosis (MS) has found that those treated with rituximab<\/em> experienced significantly higher rates of hospitalizations, infections, and hypogammaglobulinemia compared to patients on ocrelizumab<\/em>. The study analyzed data from UCSF and a larger University of California\u2013wide cohort over a four-year follow-up period.<\/p>\n

At UCSF, 18.6% of rituximab-treated patients experienced at least one hospitalization, compared to 8.8% of those on ocrelizumab. In the UC-wide validation cohort, the difference was even more pronounced\u201435.3% of rituximab patients were hospitalized versus 12.2% of those on ocrelizumab. Hospitalization rates related to infections were also markedly higher in the rituximab group, including significantly increased cases of urinary tract infections, pneumonia, cellulitis, and vaginitis.<\/p>\n

The risk of developing hypogammaglobulinemia was also greater among rituximab patients, with a 2 to 4-fold higher likelihood of low serum IgG levels (see Figure below). These patients were also more likely to require intravenous immunoglobulin (IVIg) treatment. <\/p>\n

Even after adjusting for dosage, treatment duration, and potential selection bias, the differences in hospitalization and infection rates remained significant.<\/p>\n

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Figure: The time to hypogammaglobulinemia, defined as serum IgG levels below 565\u2009mg\/dL, was evaluated. In the UCSF cohort, the Kaplan\u2013Meier estimated cumulative incidence of hypogammaglobulinemia at week 192 was 4.65% for patients on ocrelizumab and 20.02% for those on rituximab. In the UC-wide cohort, the rates were 7.22% for ocrelizumab and 26.52% for rituximab. UCSF\u2009=\u2009University of California \u2013 San Francisco.<\/figcaption><\/figure>\n<\/div>\n

While there was a trend toward greater disability progression in the rituximab group, this finding was not statistically significant. Still, the overall data suggest that ocrelizumab may offer a more favorable safety profile than rituximab for long-term MS management, especially in terms of infection-related outcomes. I did wander if a similar comparison was performed in the Scandinavian countries, you’d get the same data.<\/p>\n

Abstract<\/h2>\n

Ann Neurol.\u00a02025 Sep 8.<\/p>\n

Comparative Safety Profiles of Ocrelizumab and Rituximab in Multiple Sclerosis Treatment Using Real-World Evidence<\/h4>\n

Gabriel Cerono<\/a>\u00a0<\/sup>,\u00a0Bruce A C Cree<\/a>\u00a0<\/sup>,\u00a0Stephen L Hauser<\/a>\u00a0<\/sup>,\u00a0Sergio E Baranzini<\/a>\u00a0<\/sup><\/p>\n