Early treatment with high-efficacy DMTs can provide long-term benefits on MS disease outcomes. Understanding of ocrelizumab effectiveness in early-stage MS is still limited.

Treatment-naive patients with early-stage RRMS from ENSEMBLE receiving ocrelizumab were matched to NTD intent-to-treat (ITT) patients initiating interferon β-1a/-1b, glatiramer acetate, dimethyl fumarate and teriflunomide as index therapies. We applied propensity-score methods targeting a 2:1 matching ratio, controlling for seven baseline covariates, including brain-imaging activity. No evidence of disease activity (NEDA-2; including no relapses or 24-week confirmed disease worsening [CDW]) up to 120 weeks was explored as an efficacy outcome.

Overall, 301 ENSEMBLE patients were matched to 198 NTD–ITT patients. Baseline covariates were similar and well-balanced post-matching (standardized mean difference <0.2). The number of patients achieving NEDA-2 at Week 120 was 238 (79.1%) and 122 (61.6%) in the matched ENSEMBLE and NTD–ITT cohorts, respectively. The odds ratio (OR; 95% CI) comparing ENSEMBLE versus NTD–ITT cohort for NEDA-2 were 2.30 (1.50–3.52), primarily driven by an effect on relapses whereas there was no significant effect on 24-week CDW. Treatment switches including to high-efficacy DMTs occurred across the treatment pathways in NTD–ITT cohort.