MS Decisions - drug comparison results

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Drug name	Ocrevus	Kesimpta	Ocrevus
Chemical name This is the name of the active chemical in the drug.	Ocrelizumab	Ofatumumab	Ocrelizumab
When was the drug introduced to the NHS?	2018	2021	2024
What type of MS is the drug for? Clinically isolated syndromeFirst episode of symptoms that may go on to become MS. Active relapsing remitting MSTwo relapses in the past two years, or one relapse plus MRI evidence of MS activity. Very active relapsing remitting MSTwo or more severe or disabling relapses in the past year and show new lesions on two consecutive MRI scans.	Active relapsing remitting MS Very active relapsing remitting MS	Active relapsing remitting MS Very active relapsing remitting MS	Active relapsing remitting MS Very active relapsing remitting MS Early Primary Progressive MS
How do I take the drug? Self-injectionInto muscle or under the skin. Auto-injector devices are available and full training given PillMay be tablet or capsule Intravenous infusion (drip) in hospitalGenerally in outpatient clinic but some DMDs require a hospital stay	Intravenous infusion (drip) in hospital clinic	Self-injected under the skin	Injection under the skin (subcutaneous) given by a health professional
How often do I need to take the drug?	Once every six months	Once a month	Once every six months
How is it monitored? What tests will I have while taking the DMD, to ensure that my MS team can detect any safety issues? For further information see our tests and check-ups FAQs.	Health check at each infusion	No routine monitoring required	Health check at each injection
How effective is the drug at reducing relapses? Disease modifying drugs can be categorised based on how effective they are at reducing the frequency of relapses in people with relapsing remitting MS.	Highly effective – reduces relapse frequency by around 2/3	Highly effective – reduces relapse frequency by around 2/3	Highly effective – reduces relapse frequency by around 2/3
Will it increase my risk of infections? Is there an increased risk of infection while you are taking this DMD? Including chest infections, colds, coughs and urinary tract infections.	Higher risk of infection	Some increased risk of infection	Higher risk of infection
What vaccines can I take? How does this DMD affect the safety and effectiveness of vaccines?	Complete vaccines before treatment. No live vaccines	Complete vaccines before treatment. No live vaccines	Complete vaccines before treatment. No live vaccines
Can this be taken during pregnancy? Can this be taken during pregnancy? For further information see our pregnancy and treatment FAQs.	Not usually recommended but may be used in some circumstances	Not usually recommended but may be used in some circumstances	Not usually recommended but may be used in some circumstances
Can this be taken while breastfeeding? Can this be taken while breastfeeding? For further information see our pregnancy and treatment FAQs.	Not usually recommended	Yes	Not usually recommended
Common or mild side effects Common side effects affecting more than 1 person in 100. For full details see individual drug entries. You can also read our effects of treatment FAQs.	Infusion associated reactions Chest infections Herpes infection (cold sore or shingles) Infection of the stomach and bowel (gastroenteritis) Viral infections Skin infection (cellulitis)	Injection-site reactions (redness, pain, itching and swelling at injection site) Injection-related reactions (fever, headache, muscle pain, chills and tiredness) Infections including coughs, colds, chest infections and cold sores (oral herpes)	Injection site reactions Chest infections Herpes infection (cold sore or shingles) Infection of the stomach and bowel (gastroenteritis) Viral infections Skin infection (cellulitis)
Rare or serious side effects Less common side effects affecting fewer than 1 person in 100. For full details see individual drug entries. You can also read our effects of treatment FAQs.	Potential risk of PML (brain infection) As of June 2024, 16 confirmed cases of PML out of more than 350,000 people taking Ocrevus globally.	Potential risk of PML (brain infection) No cases reported during clinical trials of this dose, but some cases in people taking higher doses for other conditions.	Potential risk of PML As of June 2024, 16 confirmed cases of PML out of more than 350,000 people taking Ocrevus globally.
Additional information Anything else that might affect the choice of DMD that is right for you.	Approved for active relapsing remitting MS or very active relapsing remitting MS, if Lemtrada is not suitable for you.	Approved for active relapsing remitting MS or very active relapsing remitting MS.	Approved for active relapsing remitting MS or very active relapsing remitting MS, if Lemtrada is not suitable for you. You may start your Ocrevus treatment via infusion and switch to injection later if appropriate.

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Drug name	Chemical name This is the name of the active chemical in the drug.	When was the drug introduced to the NHS?	What type of MS is the drug for? Clinically isolated syndromeFirst episode of symptoms that may go on to become MS. Active relapsing remitting MSTwo relapses in the past two years, or one relapse plus MRI evidence of MS activity. Very active relapsing remitting MSTwo or more severe or disabling relapses in the past year and show new lesions on two consecutive MRI scans.	How do I take the drug? Self-injectionInto muscle or under the skin. Auto-injector devices are available and full training given PillMay be tablet or capsule Intravenous infusion (drip) in hospitalGenerally in outpatient clinic but some DMDs require a hospital stay	How often do I need to take the drug?	How is it monitored? What tests will I have while taking the DMD, to ensure that my MS team can detect any safety issues? For further information see our tests and check-ups FAQs.	How effective is the drug at reducing relapses? Disease modifying drugs can be categorised based on how effective they are at reducing the frequency of relapses in people with relapsing remitting MS.	Will it increase my risk of infections? Is there an increased risk of infection while you are taking this DMD? Including chest infections, colds, coughs and urinary tract infections.	What vaccines can I take? How does this DMD affect the safety and effectiveness of vaccines?	Can this be taken during pregnancy? Can this be taken during pregnancy? For further information see our pregnancy and treatment FAQs.	Can this be taken while breastfeeding? Can this be taken while breastfeeding? For further information see our pregnancy and treatment FAQs.	Common or mild side effects Common side effects affecting more than 1 person in 100. For full details see individual drug entries. You can also read our effects of treatment FAQs.	Rare or serious side effects Less common side effects affecting fewer than 1 person in 100. For full details see individual drug entries. You can also read our effects of treatment FAQs.	Additional information Anything else that might affect the choice of DMD that is right for you.
Ocrevus	Ocrelizumab	2018	Active relapsing remitting MS Very active relapsing remitting MS	Intravenous infusion (drip) in hospital clinic	Once every six months	Health check at each infusion	Highly effective – reduces relapse frequency by around 2/3	Higher risk of infection	Complete vaccines before treatment. No live vaccines	Not usually recommended but may be used in some circumstances	Not usually recommended	Infusion associated reactions Chest infections Herpes infection (cold sore or shingles) Infection of the stomach and bowel (gastroenteritis) Viral infections Skin infection (cellulitis)	Potential risk of PML (brain infection) As of June 2024, 16 confirmed cases of PML out of more than 350,000 people taking Ocrevus globally.	Approved for active relapsing remitting MS or very active relapsing remitting MS, if Lemtrada is not suitable for you.
Kesimpta	Ofatumumab	2021	Active relapsing remitting MS Very active relapsing remitting MS	Self-injected under the skin	Once a month	No routine monitoring required	Highly effective – reduces relapse frequency by around 2/3	Some increased risk of infection	Complete vaccines before treatment. No live vaccines	Not usually recommended but may be used in some circumstances	Yes	Injection-site reactions (redness, pain, itching and swelling at injection site) Injection-related reactions (fever, headache, muscle pain, chills and tiredness) Infections including coughs, colds, chest infections and cold sores (oral herpes)	Potential risk of PML (brain infection) No cases reported during clinical trials of this dose, but some cases in people taking higher doses for other conditions.	Approved for active relapsing remitting MS or very active relapsing remitting MS.
Ocrevus	Ocrelizumab	2024	Active relapsing remitting MS Very active relapsing remitting MS Early Primary Progressive MS	Injection under the skin (subcutaneous) given by a health professional	Once every six months	Health check at each injection	Highly effective – reduces relapse frequency by around 2/3	Higher risk of infection	Complete vaccines before treatment. No live vaccines	Not usually recommended but may be used in some circumstances	Not usually recommended	Injection site reactions Chest infections Herpes infection (cold sore or shingles) Infection of the stomach and bowel (gastroenteritis) Viral infections Skin infection (cellulitis)	Potential risk of PML As of June 2024, 16 confirmed cases of PML out of more than 350,000 people taking Ocrevus globally.	Approved for active relapsing remitting MS or very active relapsing remitting MS, if Lemtrada is not suitable for you. You may start your Ocrevus treatment via infusion and switch to injection later if appropriate.

Drug name

Chemical name

When was the drug introduced to the NHS?

What type of MS is the drug for?

Clinically isolated syndromeFirst episode of symptoms that may go on to become MS.
Active relapsing remitting MSTwo relapses in the past two years, or one relapse plus MRI evidence of MS activity.
Very active relapsing remitting MSTwo or more severe or disabling relapses in the past year and show new lesions on two consecutive MRI scans.

How do I take the drug?

How often do I need to take the drug?

How is it monitored?

How effective is the drug at reducing relapses?

Will it increase my risk of infections?

What vaccines can I take?

Can this be taken during pregnancy?

Can this be taken while breastfeeding?

Common or mild side effects

Rare or serious side effects

Additional information

Ocrevus

Ocrelizumab

2018

Active relapsing remitting MS
Very active relapsing remitting MS

Intravenous infusion (drip) in hospital clinic

Once every six months

Health check at each infusion

Highly effective – reduces relapse frequency by around 2/3

Higher risk of infection

Complete vaccines before treatment. No live vaccines

Not usually recommended but may be used in some circumstances

Not usually recommended

Infusion associated reactions
Chest infections
Herpes infection (cold sore or shingles)
Infection of the stomach and bowel (gastroenteritis)
Viral infections
Skin infection (cellulitis)

Potential risk of PML (brain infection)

As of June 2024, 16 confirmed cases of PML out of more than 350,000 people taking Ocrevus globally.

Approved for active relapsing remitting MS or very active relapsing remitting MS, if Lemtrada is not suitable for you.

Kesimpta

Ofatumumab

2021

Active relapsing remitting MS
Very active relapsing remitting MS

Self-injected under the skin

Once a month

No routine monitoring required

Highly effective – reduces relapse frequency by around 2/3

Some increased risk of infection

Complete vaccines before treatment. No live vaccines

Not usually recommended but may be used in some circumstances

Yes

Injection-site reactions (redness, pain, itching and swelling at injection site)
Injection-related reactions (fever, headache, muscle pain, chills and tiredness)
Infections including coughs, colds, chest infections and cold sores (oral herpes)

Potential risk of PML (brain infection)

No cases reported during clinical trials of this dose, but some cases in people taking higher doses for other conditions.

Approved for active relapsing remitting MS or very active relapsing remitting MS.

Ocrevus

Ocrelizumab

2024

Active relapsing remitting MS
Very active relapsing remitting MS
Early Primary Progressive MS

Injection under the skin (subcutaneous) given by a health professional

Once every six months

Health check at each injection

Highly effective – reduces relapse frequency by around 2/3

Higher risk of infection

Complete vaccines before treatment. No live vaccines

Not usually recommended but may be used in some circumstances

Not usually recommended

Injection site reactions
Chest infections
Herpes infection (cold sore or shingles)
Infection of the stomach and bowel (gastroenteritis)
Viral infections
Skin infection (cellulitis)

Potential risk of PML

As of June 2024, 16 confirmed cases of PML out of more than 350,000 people taking Ocrevus globally.

Approved for active relapsing remitting MS or very active relapsing remitting MS, if Lemtrada is not suitable for you.
You may start your Ocrevus treatment via infusion and switch to injection later if appropriate.

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