Ocrevus (ocrelizumab) vs Zeposia (ozanimod)

Ocrevus (ocrelizumab) is a monoclonal antibody that targets CD20-positive B cells, which are thought to play a role in the pathogenesis of multiple sclerosis (MS); it is administered via intravenous infusion and is approved for both relapsing-remitting and primary progressive forms of MS. Zeposia (ozanimod) is a sphingosine 1-phosphate receptor modulator taken orally, which traps immune cells in lymph nodes, reducing their ability to contribute to nerve damage; it is approved for the treatment of relapsing forms of MS, including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease. When deciding between the two, considerations include mode of administration, the specific type of MS being treated, and individual patient factors such as comorbidities and preference for treatment regimen.

Difference between Ocrevus and Zeposia

Metric	Ocrevus (ocrelizumab)	Zeposia (ozanimod)
Generic name	Ocrelizumab	Ozanimod
Indications	Primary Progressive Multiple Sclerosis (PPMS), Relapsing-Remitting Multiple Sclerosis (RRMS)	Relapsing forms of Multiple Sclerosis (MS), Ulcerative Colitis
Mechanism of action	CD20-directed cytolytic antibody	Sphingosine 1-phosphate receptor modulator
Brand names	Ocrevus	Zeposia
Administrative route	Intravenous infusion	Oral
Side effects	Infusion reactions, infections, skin cancer, depression, pain	Upper respiratory infection, liver enzyme elevation, hypertension, urinary tract infection, back pain
Contraindications	Active hepatitis B infection, history of life-threatening infusion reaction to ocrelizumab	Recent (last 6 months) myocardial infarction, unstable angina, stroke, transient ischemic attack, decompensated heart failure requiring hospitalization, Class III/IV heart failure, Mobitz type II second or third-degree atrioventricular block, sick sinus syndrome, sinoatrial heart block, active infection, immunocompromised state
Drug class	Monoclonal antibody	Sphingosine 1-phosphate receptor modulator
Manufacturer	Genentech (Roche)	Bristol Myers Squibb

Efficacy

Ocrevus (Ocrelizumab) Efficacy in Multiple Sclerosis

Ocrevus (ocrelizumab) is a monoclonal antibody designed to selectively target CD20-positive B cells, which are believed to play a key role in the pathogenesis of multiple sclerosis (MS). The efficacy of Ocrevus in treating MS has been demonstrated in several key clinical trials, including the OPERA I and II studies for relapsing forms of MS, and the ORATORIO study for primary progressive MS (PPMS). In these trials, Ocrevus has shown to reduce the annual relapse rate, delay the progression of disability, and decrease the number of lesions on MRI scans compared to the control groups.

For relapsing MS, the OPERA studies showed that Ocrevus reduced the annual relapse rate by nearly 50% compared to interferon beta-1a, a commonly used MS therapy. Moreover, the proportion of patients who experienced disability progression was significantly lower in the Ocrevus group. In the ORATORIO study, which focused on PPMS, Ocrevus became the first therapy to demonstrate efficacy in slowing disease progression in this form of MS, which previously had no approved treatments.

Zeposia (Ozanimod) Efficacy in Multiple Sclerosis

Zeposia (ozanimod) is an oral sphingosine 1-phosphate receptor modulator that traps immune cells in lymph nodes, preventing them from entering the central nervous system where they could cause damage to nerve cells. The efficacy of Zeposia in treating relapsing forms of MS, including clinically isolated syndrome, relapsing-remitting MS, and active secondary progressive MS, has been established in the SUNBEAM and RADIANCE Part B clinical trials. In these studies, Zeposia demonstrated a significant reduction in annual relapse rates and MRI lesion activity compared to interferon beta-1a.

In the SUNBEAM trial, Zeposia reduced the annual relapse rate by approximately 48% over one year compared to interferon beta-1a. The RADIANCE Part B study showed similar results over a two-year period. Additionally, Zeposia was associated with a reduction in the number of new or enlarging T2 MRI lesions and the number of gadolinium-enhancing lesions. These findings support the efficacy of Zeposia as a treatment option for patients with relapsing forms of MS, offering the convenience of an oral medication with a favorable efficacy profile.

Regulatory Agency Approvals

Ocrevus

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Health Canada
Therapeutic Goods Administration (TGA), Australia
Medsafe (NZ)

Zeposia

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Health Canada
Therapeutic Goods Administration (TGA), Australia

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