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Patients with relapsing forms of multiple sclerosis (MS) often continue to have disease activity and disability progression in spite of treatment with disease-modifying drugs, creating a need for new therapies.
Two identical phase III trials, published in The New England Journal of Medicine (online, 19 January 2017), compared the efficacy of ocrelizumab (600mg every 24 weeks), a monoclonal antibody that targets B immune cells, with subcutaneous interferon beta-1a (44μg three times weekly) in 1,656 patients with relapsing MS[1]
.
Over 96 weeks, the annualised relapse rate was 0.16 in ocrelizumab-treated patients compared with 0.29 in interferon-treated patients in both trials (P<0.001). Ocrelizumab was also associated with a lower rate of disability progression than interferon at 12 and 24 weeks.
Another trial, concurrently published in The New England Journal of Medicine
[2]
, showed that ocrelizumab also reduced rates of 12-week disability progression from 39.3% with placebo to 32.9% in patients with primary-progressive MS.
Extended follow-up in both forms of the disease is needed to confirm the long-term risk-benefit profile of ocrelizumab, the research teams conclude.
References
[1] Hauser SL, Bar-Or A, Comi G et al. Ocrelizumab versus interferon beta-1a in relapsing multiple sclerosis. NEJM 2016; 375:2446-56. doi: 10.1056/NEJMoa1606043
[2] Montalban X, Hauser SL, Kappos L et al. Ocrelizumab versus placebo in primary progressive multiple sclerosis. NEJM 2016; doi: 10.1056/NEJMoa1606468