Deciding factors in the shifting MS treatment landscape

The new drugs in MS show injectables can compete with orals. The next compounds will test that further

The efficacy and convenience advantages that established oral medicines as the go-to therapy in multiple sclerosis are the same factors now squeezing them out.

Two years post-launch, the success of injectable Ocrevus ocrelizumab from Roche (SIX:ROG; OTCQX:RHHBY) is challenging the oral paradigm, overturning the conventional wisdom that oral is better.

For Ocrevus, produced by Roche’s Genentech unit, the semi-annual dosing schedule mitigates the convenience drawback of an infusion. Its benefits include improved slowing of disability and few side effects. That overall profile has propelled Ocrevus to the treatment of choice for newly diagnosed relapsing-remitting multiple sclerosis (RRMS).

Moreover, the drug has created a precedent that gives physicians new considerations when the next two therapies hit the market -- the injectable ofatumumab from Novartis AG (NYSE:NVS; SIX:NOVN) and the small molecule ozanimod from Celgene Corp. (NASDAQ:CELG). The decision will be driven by the balance of patient preferences for the former versus safety language on the label for the latter.

“Part of the concern early on was that there would be a trade-off between safety, tolerability and efficacy, but it turns out that these more

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