Ocrelizumab May Improve Cognition in Patients At Risk for Progressive Multiple Sclerosis

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Treatment with ocrelizumab was associated with greater improvements in SDMT than IFNβ-1a in patients with baseline SDMT impairment.
Treatment with ocrelizumab was associated with greater improvements in SDMT than IFNβ-1a in patients with baseline SDMT impairment.
The following article is part of conference coverage from the 2018 Annual Meeting of the Consortium of Multiple Sclerosis Centers in Nashville, Tennesssee. Neurology Advisor's staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from CMSC 2018.

Treatment with ocrelizumab may offer a protective benefit on cognitive function in patients with relapsing multiple sclerosis (RMS), according to a study presented at the 2018 Annual Meeting of the Consortium of Multiple Sclerosis Centers, held May 30-June 2 in Nashville, Tennessee.

Cognitive impairment is common in patients with multiple sclerosis (MS) and considerably impacts quality of life, [and] the probability of cognitive deficits increases with progressive disease,” the study researchers said.

Researchers randomly assigned patients with RMS at risk for developing progressive disease to either 600 mg ocrelizumab (n=186) every 24 weeks or 3-times-weekly subcutaneous interferon beta-1a (IFNβ-1a) 44 µg (n=180) for 96 weeks. Patients had a baseline Expanded Disability Status Scale score of ≥4 and a pyramidal Kurtzke Functional Systems Score of ≥2. At baseline and every 12 weeks, patients underwent the Symbol Digit Modalities Test (SDMT). Moderate impairment was defined as scores of ≥2 SD below population norms on the SDMT. Additionally, clinically meaningful improvements were defined as a ≥4-point increase on the SDMT over a 96-week period.

At baseline, patients assigned to ocrelizumab and IFNβ-1a had mean (SE) baseline SDMT scores of 39.4 (1.6) and 39.5 (1.6), respectively. Patients treated with ocrelizumab experienced a significantly greater improvement in their baseline SDMT score compared with patients treated with IFNβ-1a over 96 weeks (6.2 [1.2]) vs IFNβ-1a (2.6 [1.2]) (P =.023).

In addition, treatment with ocrelizumab was associated with greater (SE) improvements in SDMT than IFNβ-1a in patients with baseline SDMT impairment (ocrelizumab: n=116, mean [SE] SDMT score = 27.9 [1.0]; IFNβ-1a: n=107, mean [SE] SDMT score = 28.2 [0.9]; 10.5 [1.4]) vs 6.0 [1.4]; P =.011). There were also significantly greater improvements in the SDMT of ≥4 points by 48 weeks in ocrelizumab- vs IFNβ-1a-treated patients (51.2% vs 39.4%; P =.040). Improvements associated with ocrelizumab were maintained at 96 weeks (62.2% vs 46.5%; P =.009).

“Ocrelizumab demonstrated a positive impact on cognition as measured by the SDMT in patients with relapse MS at increased risk of developing progressive disease,” the investigators concluded, “including those with baseline SDMT impairment.”

For more coverage of CMSC 2018, click here.

Reference

Benedict RH, de Seze J, Hauser SL, et al. Impact of ocrelizumab on cognition in patients at increased risk of developing progressive disease. Presented at: 32nd Annual Meeting of the Consortium of Multiple Sclerosis Centers. May 30-June 2, 2018; Nashville, Tennessee. Abstract DX67.

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