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Is Kesimpta better than Ocrevus?

Medically reviewed by Philip Thornton, DipPharm. Last updated on Nov 3, 2022.

Is Kesimpta more effective than Ocrevus?

Official answer

by Drugs.com

  • In patients with relapsing forms of multiple sclerosis, Kesimpta is thought to be more effective than Ocrevus in some ways, but no clinical trials have directly compared the two drugs

  • Ocrevus is the only one of the two drugs approved to treat primary progressive multiple sclerosis

Kesimpta (ofatumumab) and Ocrevus (ocrelizumab) are prescription medications used to treat relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults. Ocrevus is also used to treat primary progressive MS in adults.

Kesimpta and Ocrevus have not been compared head-to-head in a clinical trial in patients with relapsing forms of MS, but an indirect comparison indicates that Kesimpta is better than Ocrevus when looking at certain measures of effectiveness.

Researchers have compared the data from two Kesimpta trials (ASCLEPIOS I and ASCLEPIOS II) with data from two Ocruvus trials (OPERA I AND OPERA II) using simulated treatment comparisons.

The researchers found that for the patients with three- and six-month confirmed disability progression, the two drugs appear to be similarly effective. However, treatment with Kesimpta appears to provide a significant improvement in annualized relapse rates (rate ratio: 0.60, 95% CI: 0.43-0.84) compared with Ocrevus, meaning that patients treated with Kesimpta were less likely to experience relapses. Magnetic resonance imaging (MRI) outcomes, which looked at the proportion of patients with gadolinium-enhancing T1 lesions and brain volume change, and NEDA-3 (No Evidence of Disease Activity 3 parameter composite measure) outcomes also significantly favored Kesimpta over Ocrevus.

Kesimpta and Ocrevus are both CD20-directed cytolytic monoclonal antibodies that target B-cells. Exactly how these drugs work is unknown, but it’s thought to be related to their ability to deplete B cells, which reduces the number of relapses patients with MS experience and slows the progression of the disease.

Kesimpta Ocrevus
Company Novartis Pharmaceuticals Genentech
Approved by the FDA 2009 2017
Active ingredient Ofatumumab Ocrelizumab
Uses Used to treat:
  • Relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.
 Used to treat:
  • Relapsing forms of MS, to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.
  • Primary progressive MS, in adults.
Drug class CD20 monoclonal antibody CD20 monoclonal antibody
Route of administration Subcutaneous (under the skin) injections - Given weekly for three weeks then monthly Intravenous (infusion) injection - Given twice two weeks apart then six-monthly

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References

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Ocrevus is not chemotherapy, it is a type of targeted treatment that works by binding to a protein called CD20 that is present on the surface of B-lymphocytes. Ocrevus may be used to reduce inflammation, reduce the risk of relapse, and delay the rate of disease progression in people with multiple sclerosis.

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The first two times you have Ocrevus it will be infused over at least 2.5 hours, depending on how you tolerate it. However, the whole infusion appointment will take around 5 to 6 hours, because there is a pre-infusion check-up, during which you will receive medications that reduce infusion reactions, and you will need to wait for at least an hour post-infusion so your healthcare team can monitor you for any side effects or infusion reactions. Continue reading

Ocrevus works in MS by targeting a specific protein, called CD20 that exists on the surface of immature and mature B-lymphocytes. B lymphocytes are a type of white blood cell which are thought to contribute to the development of MS in several different ways, including secreting antibodies during an MS attack that cause inflammation which damages the myelin coating around nerve cells in the brain and spinal cord. When Ocrevus binds to CD20, it causes B-cells to self-destruct or disintegrate, which reduces the number of MS relapse and the rate of disability progression. Continue reading

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