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Ocrelizumab (Ocrevus; Roche) is effective in preventing progression of multiple sclerosis (MS) in patients with advanced disease — the only treatment to show efficacy in a phase III trial — researchers have found.
Results from the ‘ORATORIO-HAND’ trial, published in The Lancet on 30 May 2026, have revealed that ocrelizumab significantly reduced the risk of disability worsening, such as reduced upper limb and hand function, in wheelchair-dependent patients.
The study involved more than 1,000 patients aged 18–65 years with primary progressive MS, who had disability ranging from middle to quite advanced.
Patients were randomised 1:1 to receive either IV ocrelizumab 600mg or placebo every 6 months for 144 weeks or until a pre-specified number of progression events had occurred.
In the subgroup of wheelchair-dependent patients, 56% (n=46/82) of patients receiving placebo experienced disability worsening, compared with 36% (n=29/81) of patients receiving ocrelizumab.
The study results also showed ocrelizumab delays disability progression in MS patients in general, finding 33% (165/505) of patients receiving ocrelizumab experienced sustained worsening of disability lasting for at least 12 weeks, compared with 40% (205/508) in the placebo group.
The authors noted: “For individuals with advanced MS, especially those using a wheelchair for ambulation, maintenance of manual dexterity is crucial to perform daily activities, preserve independence, and sustain quality of life.”
Ocrelizumab is a disease-modifying therapy for patients with active relapsing or primary progressive MS. In July 2024, a ten-minute injection was rolled out on the NHS.
Olga Tanda, advanced neurology pharmacist independent prescriber at Great Western Hospitals NHS Foundation Trust, commented: “This research is particularly relevant in the current MS treatment landscape because it focuses on primary progressive MS, a form of the disease for which treatment options remain extremely limited. Unlike relapsing-remitting MS, where several disease-modifying therapies are available, ocrelizumab is currently the only licensed treatment shown to modify disease progression in primary progressive MS.
“Traditionally, clinical assessment and treatment decisions in primary progressive MS have focused heavily on preserving lower-limb function and mobility. This emphasis has also influenced access to disease-modifying therapies, as ambulatory function remains a key consideration when determining treatment eligibility. However, far less attention has been given to the importance of preserving upper-limb function, particularly in people with advanced disability and higher Expanded Disability Status Scale scores.
She added: “By demonstrating that preservation of upper-limb function can meaningfully sustain independence in people with advanced primary progressive MS, this study offers an important new perspective on how treatment value should be assessed. These findings have the potential to influence future national discussions around treatment funding, access and the broader definition of meaningful clinical benefit in progressive MS.”
MS is a progressive autoimmune disease of the central nervous system that is estimated to affect more than 150,000 people in the UK, including more than 120,000 people in England.
It is a lifelong disease that can cause a range of symptoms, such as fatigue, difficulty walking, vision problems and muscle stiffness and spams. Disease-modifying therapies can help to reduce relapses and slow down progression of the disease.
