48 msfocusmagazine.org Ocrelizumab shown to be effective in both progressive, relapsing MS Three separate clinical trials discovered that ocrelizumab can significantly reduce new attacks in patients with relapsing MS, as well as slow the progression of symptoms caused by primary progressive MS. In one study, patients with primary progressive MS were randomized to receive eitherocrelizumab ora placebo.The proportion of patients with 12-week confirmed disability progression was 39.3 percent with the placebo versus 32.9 percent with ocrelizumab. After 24 weeks, the proportion with confirmed disability progression was 35.7 percent with placebo versus 29.6 percent with ocrelizumab. By week 120, timed 25-foot walk worsened by55.1 percent forplaceboversus 38.9 percent for ocrelizumab. Patients given ocrelizumab were also found to have fewernewbrain lesions and less brain volume loss than those given the placebo. Researchers also tested ocrelizumab in two separate studies of patients with relapsing remitting MS. In both studies, patients were randomized to receive either ocrelizumab or an already established treatment for relapsing MS: subcutaneous interferon-beta, injected three times weekly. Relapse rates in patients given ocrelizumab were 46 percent lower in one study and 47 percent lower in the other. Ocrelizumab was found to reduce the risk of disability progression after 12 weeks and 24 weeks, and reduced the number of new brain lesions. The studies were published in the New England Journal of Medicine. Thrower – Ocrelizumab will, at long last, bring an FDA-approved treatment option for people with primary progressive MS. In addition, it will be another option for relapsing forms of MS. The drug targets the CD20 receptor on developing B-cells in the immune system. This mechanism of action is similar to rituximab. Both drugs are given as a twice- yearly intravenous infusion. Rituximab is not FDA-approved for MS, but is used off-label in some cases of MS and commonlyin the cousin of MS, neuromyelitis optica. Ocrelizumab appears to have a good safety profile, although it is likely that the drug may come with a warning label regarding progressive multifocal leukoencephalopathy.To date, there have been no cases of PMLwith ocrelizumab, but there have been 10 cases with the similar drug, rituximab. Nine of those 10 cases were when rituximab was used to treat lupus or rheumatoid arthritis in combination with an Medicine & Research Doctor’s Notes The Doctor’s Notes column includes analysis from Ben Thrower, M.D., MS Focus Senior Medical Advisor. Dr. Thrower draws from the top news stories of the quarter and explains what the news means to you, the person with MS.