Briumvi vs Ocrevus: How do they compare?

Key Points

• Briumvi (ublituximab) and Ocrevus (ocrelizumab) are two injectable medications that may be used to treat multiple sclerosis in adults.
• Briumvi and Ocrevus are both B-cell therapies and work the same way.
• Head-to-head trials directly comparing the Briumvi and Ocrevus have not been conducted, making it difficult to definitively determine which is more effective.
• Both Briumvi and Ocrevus carry a risk of infusion reactions and infections.

Briumvi (ublituximab) and Ocrevus (ocrelizumab) are intravenous (IV) infusion medications used to treat multiple sclerosis (MS). Both are B-cell therapies that work in similar ways, but they have some differences in their approvals, dosing, and side effects.

While there have not been head-to-head comparison studies in patients with MS, both medications work well and have similar side effects. In this article, we will review some similarities and differences between Briumvi and Ocrevus.

Key Differences

What Are Briumvi and Ocrevus Used For?

Both Briumbi and Ocrevus are FDA approved for relapsing forms of multiple sclerosis. This includes clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease. However, Ocrevus is additionally approved to treat primary progressive MS.

Ocrevus was FDA approved in 2017, while Briumvi was approved in 2022. Both medications are currently only approved in adults, since there haven’t been enough studies in children to know if they are safe or effective.

How Do Briumvi and Ocrevus Work?

Both medications target B-cells expressing the CD20 protein, which are believed to contribute to nerve damage in MS. While Briumvi and Ocrevus bind to different parts of B-cells, no head-to-head studies have compared their effectiveness directly.

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Effectiveness of Briumvi vs. Ocrevus

There have not been head-to-head trials comparing Ocrevus and Briumvi. However, separate studies evaluated how well these medications work to treat MS.

Ocrevus

• In studies of patients with RMS, up to 83% of patients taking Ocrevus were relapse free at year 2.
• In a 120-week clinical trial of patients with PPMS, those taking Ocrevus were less likely to have a 12-week confirmed disability progression compared to placebo.

Briumvi
In two clinical trials involving over 1,000 patients with RMS, Briumvi reduced relapses by up to 59% when compared to teriflunomide.

Dosing and Infusion Time

Both medications require IV administration by a healthcare provider. However, infusion times differ:

Briumvi:

• First dose: 150 mg IV
• Second dose (2 weeks later): 450 mg IV
• Maintenance dose: 450 mg IV every 6 months
• Shorter infusion time (~4 hours initially, ~1 hour for subsequent doses)

Ocrevus:

• First dose: 300 mg IV
• Second dose (2 weeks later): 300 mg IV
• Maintenance dose: 600 mg IV every 6 months
• Infusions take 2.5–3.5 hours or longer

Briumvi and Ocrevus have similar side effects

The most common side effects of both Briumvi and Ocrevus include infections and infusion reactions. In clinical studies of Briumvi, 48% of patients taking it experienced infusion reactions. Additionally, 45% of patients taking Briumvi reported an upper respiratory tract infection.

In comparison, 40% of patients taking Ocrevus for relapsing forms of MS in clinical studies reported an upper respiratory tract infection, and 34% had an infusion reaction.

Other side effects reported by patients taking Briumvi or Ocrevus were lower respiratory tract infections and pain in arms or legs. These are not all side effects possible with these medications. Follow up with your healthcare provider to learn more.

Ocrevus and Cancer Risk

Ocrevus carries a warning about a possible increased risk of cancer. In clinical trials, 6 out of 781 females on Ocrevus developed breast cancer, compared to none in the group taking Rebif or placebo. Further research is needed to confirm this risk.

Conclusion

Briumvi and Ocrevus are both effective B-cell therapies for MS, with similar efficacy and side effects. Briumvi offers shorter infusion times, while Ocrevus has a broader approval for primary progressive MS. Talk to your healthcare provider to determine the best option for your condition.