The following article is part of conference coverage from the 2019 American Academy of Neurology Annual Meeting (AAN 2019) in Philadelphia, PA. 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 AAN 2019.


PHILADELPHIA — Ocrelizumab (Ocrevus®, Genentech) therapy to treat confirmed disability progression in multiple sclerosis (MS) was most effective when treatment was started earlier and was administered continuously, according to research presented at the 2019 American Academy of Neurology Annual Meeting, held May 4-10, 2019, in Philadelphia, Pennsylvania.

The investigators of this study sought to examine the efficacy of ocrelizumab vs placebo on 48-week confirmed disability progression in patients with primary progressive MS. In the extended controlled treatment period of the ORATORIO phase 3 trial (ClinicalTrials.gov identifier: NCT01194570), patients were maintained on or switched to ocrelizumab therapy; investigators analyzed time to onset of 48-week confirmed disability progression for both the extended controlled treatment period and the extended open-label extension period through 5.5 years.

Compared with placebo, ocrelizumab reduced risk of 48-week confirmed disability progression by 34% during the extended controlled treatment period (P =.001), and 72% of the study participants entered the open-label extension period. The proportion of patients with 48-week confirmed disability progression was lower in the group maintained on continuous ocrelizumab vs the group that switched to ocrelizumab from placebo. Results were reported at week 168 (30.5% vs 44.4%; P <.001), week 192 (34.8% vs 48.5%; P <.001), and week 264 (43.7% vs 53.1%; P =.03).

The investigators indicated that ocrelizumab was more effective on 48-week confirmed disability progression vs 12-week or 24-week confirmed disability progression and suggested that starting continuous ocrelizumab earlier provided consistent and sustained benefits for patients with MS and accrued disability.

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Reference

Wolinsky JS, Kappos L, Montalban X, et al. Reduction in 48-week confirmed disability progression after 5.5 years of ocrelizumab treatment in patients with primary progressive multiple sclerosis. Presented at: 2019 American Academy of Neurology Annual Meeting; May 4-10, 2019; Philadelphia, PA.