A 10-year analysis of the OPERA trials confirms that patients with relapsing MS who started ocrelizumab from the beginning had significantly less disability than those who waited 2 years on interferon. The early starters showed a 24% lower risk of disability progression and a 43% lower risk of needing a walking aid — and that gap never fully closed. No new long-term safety concerns emerged.
Ten years of follow-up data from the landmark OPERA I and II trials make a compelling case: when it comes to treating relapsing multiple sclerosis (MS), earlier is better — and the window matters. Patients who started ocrelizumab (Ocrevus) from day one maintained a meaningful disability advantage over those who spent their first two years on interferon beta-1a before switching. That head start translated into lasting protection that the delayed group never fully caught up to.
Published in JAMA Neurology, the pooled analysis of 1,656 patients found that 82.2% of continuous ocrelizumab users remained free of confirmed disability progression over 10 years. Relapse rates also dropped dramatically — from 0.139 in year 1 to just 0.016 by year 10 — and no new or cumulative safety signals emerged across more than 10,800 patient-years of exposure.
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Why it matters: These findings add rare, decade-long randomized trial data to the growing case for early high-efficacy therapy in MS — a field that has largely relied on observational studies. For clinicians, the message is clear: a 2-year treatment delay can leave a disability gap that persists long after patients switch to a more effective therapy.
