Is Kesimpta better than Ocrevus?

Q: Is Kesimpta better than Ocrevus?

In patients with relapsing forms of multiple sclerosis, Kesimpta (ofatumumab) is thought to be more effective than Ocrevus (ocrelizumab) in some ways, but no clinical trials have directly compared the two drugs Ocrevus is the only one of the two drugs approved to treat primary progressive multiple sclerosis

Medically reviewed by Kristianne Hannemann, PharmD. Last updated on March 5, 2025.

Is Kesimpta more effective than Ocrevus?

Official answer

by Drugs.com

Kesimpta (ofatumumab) may offer advantages over Ocrevus (ocrelizumab) for treating relapsing forms of multiple sclerosis (MS), but no prospective head-to-head clinical trials have compared the two. Both medications are prescribed for relapsing MS, but Ocrevus is also approved for primary progressive MS.

Comparing Kesimpta and Ocrevus for Relapsing MS

An indirect analysis compared data from clinical trials:

Kesimpta Trials: ASCLEPIOS I and ASCLEPIOS II
Ocrevus Trials: OPERA I and OPERA II

Key findings:

Disability Progression: Both drugs were similarly effective in reducing three- and six-month confirmed disability progression.
Relapse Rate: Kesimpta significantly reduced the annualized relapse rate (rate ratio: 0.60, 95% CI: 0.43-0.84) compared to Ocrevus, meaning fewer relapses for patients.
MRI Outcomes: Kesimpta showed better results in reducing gadolinium-enhancing T1 lesions and brain volume loss.
NEDA-3 (No Evidence of Disease Activity): Kesimpta had a greater impact on achieving disease-free activity.

A small, retrospective real-world study following patients taking Kesimpta or Ocrevus for at least 12 months found similar results.

How Do Kesimpta and Ocrevus Work?

Both medications are CD20-directed cytolytic monoclonal antibodies that target B-cells to slow disease progression and reduce relapses. The exact mechanism is not fully understood, but B-cell depletion is believed to play a key role in managing MS.

	Kesimpta	Ocrevus
Company	Novartis Pharmaceuticals	Genentech
Approved by the FDA	2009	2017
Active ingredient	Ofatumumab	Ocrelizumab
Uses	Used to treat: Relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.	Used to treat: Relapsing forms of MS, to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults. Primary progressive MS, in adults.
Drug class	CD20 monoclonal antibody	CD20 monoclonal antibody
Route of administration	Subcutaneous (under the skin) injections - Given weekly for three weeks then monthly	Intravenous (infusion) injection - Given twice two weeks apart then six-monthly

Key Takeaways

Kesimpta and Ocrevus are both effective for relapsing MS, but Kesimpta may offer advantages in reducing relapse rates and MRI disease activity. Ocrevus remains the only option approved for primary progressive MS. Discuss with your healthcare provider to determine the best treatment based on your condition and medical history.

References

Food and Drug Administration (FDA). Kesimpta Product Label. [Accessed November 3, 2022]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/125326s075lbl.pdf.
Food and Drug Administration (FDA). Ocrevus Product Label. [Accessed November 3, 2022]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/761053s029s030lbl.pdf.
Samjoo IA, Klotz L, Giovannoni G, et al. Simulated treatment comparison of efficacy outcomes for ofatumumab in ASCLEPIOS I/II versus ocrelizumab in OPERA I/II for the treatment of patients with relapsing multiple sclerosis. Mult Scler Relat Disord. 2022;66:104031. doi:10.1016/j.msard.2022.104031. https://www.msard-journal.com/article/S2211-0348(22)00539-9/fulltext.
Zanghi, A., et. al. 2024. Ocrelizumab and ofatumumab comparison: an Italian real-world propensity score matched study. In: Journal of Neurology. DOI: https://doi.org/10.1007/s00415-024-12360-x

How long does it take Ocrevus to work?

Ocrevus has some effect at reducing disability progression within about 12 weeks; however, it may take at least 6 months or possibly longer for the full effects to be seen. Continue reading

Ocrevus side effects: What are 5 key side effects to watch for?

Ocrevus can cause serious side effects such as infections, PML, infusion reactions, inflammation of the colon (colitis) infection, and malignancy. Learn about the symptoms of these side effects. Continue reading

How long does an Ocrevus infusion take?

The first two times you have Ocrevus it will be infused over at least 2.5 hours, depending on how you tolerate it. However, the whole infusion appointment will take around 5 to 6 hours, because there is a pre-infusion check-up, during which you will receive medications that reduce infusion reactions, and you will need to wait for at least an hour post-infusion so your healthcare team can monitor you for any side effects or infusion reactions. Continue reading

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