Ocrelizumab in Multiple Sclerosis: Real-world Experience from Balochistan, Pakistan

Background and Objective: Multiple sclerosis (MS) is an autoimmune demyelinating disorder affecting the central nervous system. Ocrelizumab, a disease-modifying drug for MS, is funded by Bait ul Maal Pakistan for economically disadvantaged patients in Balochistan. The objective of this study was  to evaluate the treatment response of Ocrelizumab in our population. Methods: This prospective observational study enrolled 22 patients from three tertiary care hospitals in Balochistan from July 2021 to June 2022. Patients aged 18–50 years diagnosed with MS and without contraindications for Ocrelizumab were included. The Expanded Disability Status Scale (EDSS) was calculated at baseline and at three, six, and 12 months. Patient satisfaction was assessed using a Likert scale (1 = extremely unsatisfied, 5 = extremely satisfied). Primary outcome was EDSS improvement; secondary outcomes included patient and family satisfaction. Results:  Of 22 patients, 14 were female and 8 were male, with a mean age of 33.23 ± 9.75 years. RRMS was most common (81%; n=18), followed by primary progressive MS (14%; n=3). Median EDSS improved from 5.36 ± 2.50 at baseline to 3.37 ± 2.98 at follow-up. Major improvement was seen in 20% of patients, mild improvement in 50%, and no change/worsening in 30%. Patient and family satisfaction scores were 3.14 ± 1.42 and 3.10 ± 1.30, respectively. Conclusion: Ocrelizumab is an effective, safe, and acceptable treatment for MS patients in our population. EDSS scores improved significantly from 5.36 to 3.37 at the end of the follow-up period. Both patient and family satisfaction rates were high, indicating positive real-life experiences with the treatment.