Mycobacterium Avium infection of the flexor tendon sheaths, | Figure 1

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Mycobacterium Avium infection of the flexor tendon sheaths, recurrent after 12 months on antibiotics.

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Key messages

• Ocrelizumab is a recently approved medicine to treat people with multiple sclerosis (MS). In relapsing‐remitting MS (where people experience flare‐ups of symptoms), ocrelizumab probably substantially reduces flare‐ups, may substantially reduce worsening of symptoms, and probably makes little or no difference to unwanted effects compared with interferon beta‐1a (a standard treatment for MS), 96 weeks after treatment starts.
• Compared to placebo after 120 weeks of treatment for primary progressive MS, ocrelizumab may reduce worsening of symptoms. Ocrelizumab probably increases unwanted effects but makes little or no difference to the number of serious unwanted effects.
• We need more, better‐designed studies.

Main results:

• Ocrelizumab compared with interferon beta‐1a for people with relapsing‐remitting MS, after 96 weeks of treatment:
  • probably substantially reduces the number of people who had flare‐ups;
  • may substantially reduce the number of people whose symptoms got worse;
  • probably makes little or no difference to unwanted effects;
  • may substantially reduce the number of people who stopped having treatment due to unwanted effects.
• Ocrelizumab compared with placebo for people with primary progressive MS, after 120 weeks of treatment:
  • may reduce the number of people whose symptoms got worse;
  • probably increases unwanted effects;
  • may make little or no difference to the number of serious unwanted effects and the number of people who stopped having treatment due to unwanted effects.

Our confidence in the results is moderate to low for several reasons. First, people dropped out of the studies unevenly, which meant more people had one treatment than the other. Second, there was not enough information about some of our points of interest to allow us to draw conclusions for outcomes. Finally, changes in symptoms shown by scans could have been due to causes other than disease progression.