Comparable Infection Risk of Ocrelizumab and Rituximab in Multiple Sclerosis in a Nationwide Swedish Cohort Study

In multiple sclerosis (MS), anti-CD20 therapies have been associated with increased infection risk, but whether this risk differs between rituximab and ocrelizumab is not known. Using a nationwide cohort, we studied infection risk and relapse outcomes among 16,872 treatment episodes with rituximab, ocrelizumab, or other disease-modifying therapies (DMTs) between 2014 and 2025. Infection outcomes included serious infections, hospital-diagnosed infections, and antibiotic use, and relapse risk was assessed as a marker of efficacy. Both rituximab and ocrelizumab were associated with higher infection rates than other DMTs, while relapse rates were substantially lower. Infection and relapse risks were similar between rituximab and ocrelizumab. ANN NEUROL 2026.