Breakthrough in Progressive MS: Ocrelizumab Slows Disability in Advanced Stages
A major phase III clinical trial has found that ocrelizumab significantly reduces the risk of disability progression in patients with primary progressive multiple sclerosis (PPMS), including those with advanced disability.
The ORATORIO-HAND trial, led by Queen Mary University of London and published in The Lancet on 28 May, involved over 1,000 patients across 22 countries.
Key Results: A New Standard for Advanced MS
The study demonstrated several powerful benefits of ocrelizumab compared to a placebo:
- 30% lower risk of overall disability progression.
- 41% reduction in worsening of hand and upper-limb function (measured at 12 weeks).
- 52% lower risk of requiring a wheelchair among patients who were unable to walk at the start of the study.
- 55% reduction in disability progression risk for patients showing inflammatory disease activity on initial MRI scans.
Background: Filling a Critical Treatment Gap
PPMS accounts for 10–15% of all multiple sclerosis cases. Historically, treatment options have been very limited for people in the later stages of the disease.
This trial is notable because it deliberately included patients up to age 65 and those with advanced disability—groups that are often excluded from other clinical studies.
Implications: Broader Access on the Horizon?
According to researchers, these findings suggest that ocrelizumab could benefit a much wider patient population than those who currently have access to the medication.
A key innovation of the study was its use of the 9-Hole Peg test to assess hand function. This is significant because a separate survey of patients with worsening MS found they prioritized preserving hand and arm function over lower-limb function.
Statements from Experts
"These findings show that treatment can make a meaningful difference to people with more advanced MS and help preserve hand and arm function."
— Gavin Giovannoni, lead author and Professor of Neurology at Queen Mary University of London
"These results could mean ocrelizumab is made available for more people with primary progressive MS who don't currently have access to any treatment options."
— Dr. Catherine Godbold, Senior Research Communications Manager at the MS Society