The Rate Of Disease Progression In MS Patients Treated With Rituximab And Ocrelizumab: A Comparative Study

New disease-modifying treatments (DMTs), like monoclonal antibodies (mAbs), have improved clinical outcomes and led to major shifts in MS treatment guidelines. Since these mAbs like rituximab and ocrelizumab have varying degrees of efficacy; our study aimed to evaluate and compare rituximab and ocrelizumab by terms of their potency in lowering disability scores, slowing disease progression and clinical relapse, and depleting B cells in Iraqi patient with MS. Fifty-eight Iraqi patient with MS were enrolled, and divided equally based on the medication used into two groups; 29 patients medicated with Rituximab and 29 patients medicated with Ocrelizumab. Each of EDSS, PI and clinical relapse were calculated, moreover serum Albumin was measured using Biosystem kit, while CRP measured by using immunoturbidimetric assay. B- cell depletion was measured by using flowcytometry technique. EDSS mean (before and after treatment) among patients treated with RTX didn’t show any difference (EDSS1=3.19 vs. EDSS2=3.2), while the patients treated with OCR showed a notable deterioration in EDSS even after treatments (EDSS1= 3.93 vs. EDSS2= 5.1). Moreover, there was a significant decrease in clinical relapses among RTX treated-patients (27.6%) compared to OCR treated-patients (17.17). The percent of PI in RTX group showed significant decrement than that of OCR group (44% vs. 56%), also, a high significant depletion in B cell was noticed in RTX group compared to OCR group (0.48 vs. 0.70). In contrast to OCR, which revealed a substantial worsening of EDSS following treatment, RTX demonstrated no statistically significant difference in EDSS (pre- and post-treatment). Also, patients treated with RTX had much lower rates of PI, relapses, and higher B cell depletion as compared to patients treated with OCR. So, these findings indicate that rituximab exceeds ocrelizumab in slowing the course of illness.