Ocrelizumab Lowers Patient Risk of Upper Extremity Disability in PPMS

A new assessment of ocrelizumab (Ocrevus) in patients with primary progressive multiple sclerosis (PPMS) has found the monoclonal antibody has capability to reduce patient risk of upper extremity (UE) disability progression.

In new findings from the phase 3 randomized ORATORIO trial, investigators analyzed ocrelizumab versus placebo in an intent-to-treat patient population stratified by Nine-Hole Peg Test (9HPT) and Expanded Disability Status Scale (EDSS) scores at baseline. Assessing for reduced risk of disability progression remains a focal point for progressing MS care.

Led by Edward J. Fox, MD, of Penn State Health, the team emphasized how the rare MS subtype PPMS is characterized by the gradual debilitation of patient neurological ability that could affect their everyday motor, sensory, coordination, and cognitive function.

UE impairment impacts patients’ ability to perform activities of daily living, affecting their independence and quality of life,” investigators wrote. “Moreover, the association of UE dysfunction and unemployment in patients with MS highlights the economic impact of compromised hand/arm function in MS.”

Ocrelizumab, from Genentech, was first approved by the US Food and Drug Administration (FDA) for the treatment of relapsing-remitting MS (RRMS) and PPPMS in March 2017—making history as the first therapy indicated for the latter MS subtype. Its approval was partially based on previous results to come from the ORATORIO trial series.

In using the EDSS and 9HPT scales as a metric for the therapy’s influence on disability risk reduction, the investigators were additionally providing context to ocrelizumab’s benefits for ambulation rates and MS-related costs, as both tests provide context to either facet. A clinically meaningful change in 9HPT time is commonly defined as an increase of ≥20%.

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