Clinical Report: Infection Risk Assessment of Ocrelizumab Versus Rituximab

Overview

This nationwide cohort study in Sweden compares infection-related hospitalizations and antibiotic prescriptions between patients with multiple sclerosis treated with ocrelizumab and rituximab.

Background

Multiple sclerosis (MS) is a chronic disease requiring long-term treatment to mitigate neurological disability. Anti-CD20 therapies, such as ocrelizumab and rituximab, are effective in managing MS but carry an increased risk of infections.

Data Highlights

Key Findings

• Rituximab exposure is associated with approximately 2-fold increased risk of infection-related hospitalization compared to ocrelizumab, based on the study findings.
• A meta-analysis indicated numerically higher counts of infections with ocrelizumab compared to other B-cell depleting therapies.
• Long-term follow-up studies show differences in infection risks between rituximab and ocrelizumab.
• Rituximab is widely used off-label due to its lower cost, but higher infection risks may offset economic benefits.
• The study utilized Swedish health registers to analyze infection outcomes and treatment efficacy.

Clinical Implications

Healthcare professionals should consider the infection risk associated with rituximab when prescribing treatment for multiple sclerosis.

Conclusion

This study provides insights into the comparative infection risks of ocrelizumab and rituximab in MS treatment.

Related Resources & Content

1. Cerono et al., PubMed, 2023 -- Comparable Infection Risk of Ocrelizumab and Rituximab in Multiple Sclerosis in a Nationwide Swedish Cohort Study
2. American Academy of Neurology, Guidance and consensus, 2025 -- Update: Vaccine-preventable Infections and Immunization in Multiple Sclerosis
3. conexiant — Head-to-Head Trial in Relapsing MS
4. Drugs - Real World Outcomes — Assessment of Long-Term Efficacy and Immune Response Effects of Ocrelizumab in a Real-World Patient Population
5. Blood Cancer Journal — Prevalence of Relapsed/Refractory Diffuse Large B-Cell Lymphoma (DLBCL) with Central Nervous System Involvement in a Population-Based Study of 4243 Patients from Sweden
6. Clinical Rheumatology — Rituximab in Clinical Use: Administration, Patient Compliance, Immunoglobulin Levels, Infection Risks, and Antibody Development
7. Head-to-Head Trial in Relapsing MS
8. Assessment of Long-Term Efficacy and Immune Response Effects of Ocrelizumab in a Real-World Patient Population
9. Update: Vaccine-preventable Infections and Immunization in Multiple Sclerosis
10. Ocrelizumab versus Interferon Beta-1a in Relapsing Multiple Sclerosis | New England Journal of Medicine
11. Comparable Infection Risk of Ocrelizumab and Rituximab in Multiple Sclerosis in a Nationwide Swedish Cohort Study - PubMed