Analyzing Serious Infection Risk and Long-Term Ocrelizumab Treatment in MS: Alise Carlson, MD

WATCH TIME: 3 minutes| Captions are auto-generated and may contain errors.

"The clinical trials of ocrelizumab showed that there were higher rates of mild and moderate infections, but the serious infection rates were pretty similar in that initial cohort. However, the post-marketing studies and the long-term extension studies have started to show some signal for serious infection."

Findings of clinical trials assessing B-cell–depleting therapies, such as ocrelizumab (Ocrevus; Genentech), ofatumumab (Kesimpta; Novartis), and ublituximab (Briumvi; TG Therapeutics), have demonstrated substantial efficacy in controlling disease activity and reducing long-term disability in patients with multiple sclerosis (MS). However, these approved therapies may also carry an increased risk of serious infections. Understanding the magnitude of this risk in a real-world setting may carry importance for clinicians in terms of treatment decisions and patient counseling.

An observational study presented at the 2025 European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress, held September 24-26, in Barcelona, Spain, compared the incidence of serious infections in 2551 patients treated with ocrelizumab versus 1307 patients treated with platform injectable therapies using a propensity-matched cohort. Presented by lead author Alise Carlson, MD, the study also assessed the time to first serious infection and the association between immunoglobulin levels and infection risk. Additionally, the risk of serious infection was assessed by age groups among ocrelizumab-treated patients.

In an interview with NeurologyLive^® at ECTRIMS 2025, Carlson, a staff neurologist at the Cleveland Clinic’s Mellen Center for Multiple Sclerosis, shared the findings from the study. She discussed a higher rate of serious infections observed among patients treated with ocrelizumab, with time to first serious infection shorter than in those receiving injectable therapies. Carlson also noted that age and hypogammaglobulinemia did not significantly influence infection risk. Moreover, she highlighted the evolving MS treatment landscape, emphasizing the need for therapies targeting neurodegeneration and remyelination.

Click here for more coverage of ECTRIMS 2025.

REFERENCES
1. Carlson AK, Du M, Husak S, et al. Long-term safety risks among patients with multiple sclerosis treated with ocrelizumab: An observational study. Presented at ECTRIMS Congress; September 24-26, 2025; Barcelona, Spain. Abstract O077.