New Spherix Report Finds PPMS Treatment Increased Significantly in Past Year

Since Genentech‘s Ocrevus was approved a year ago, the treatment rate of primary progressive multiple sclerosis (PPMS) has increased significantly.

However, a closer look at the data shows that other disease-modifying therapies (DMTs) are equally responsible for this increase.

The findings were reported by Spherix Global Insights in their new study titled “RealTime Dynamix: Multiple Sclerosis (US).” The results were based on a survey conducted among 101 U.S. neurologists.

According to the report, nearly one-third of patients on DMTs are taking Ocrevus. Interestingly, the PPMS treatment rate does not differ between neurologists prescribing Ocrevus and those who don’t, suggesting that Ocrevus alone is not driving this increase seen in the PPMS treatment rate.

In fact, the report shows that since the launch of Ocrevus, there has been a decline in the number of neurologists who feel comfortable prescribing Ocrevus as a first-line treatment for PPMS.

These neurologists seem to have a preference for off-label DMTs — such as Genentech’s Rituxan (rituximab), which is approved as a therapy for some autoimmune diseases. Off-label means the medication is being used in a manner not specified according to the FDA’s approved packaging label.

The Spherix report suggests that this preference for off-label DMTs may be linked to the greater familiarity of neurologists with these therapies, and with fewer payer restrictions.

Regardless of their DMT choice, neurologists who prescribe Ocrevus and those who don’t (nonprescribers) report a similar satisfactory response rate for their PPMS patients.

Patients with active secondary progressive multiple sclerosis (SPMS) with relapses represent those who are most often prescribed Ocrevus, with the numbers of SPMS patients on Ocrevus similar to those of PPMS, just 10 months since Ocrevus became available to patients.

This phenomenon may be linked to the therapy’s positive effects in relapsing MS, Sperix noted.

Still, fewer than a third of the neurologists prescribing Ocrevus for SPMS reported complete satisfaction rates with the treatment in patients with this specific disease subtype.

These findings suggest a possible deceleration of Ocrevus prescriptions for patients with active SPMS, especially with the potential approval of Novartis‘ investigational Siponimod (BAF312) for SPMS.

As for other therapies, the FDA is asking Celgene for more information before agreeing to review ozanimod as a treatment for relapsing forms of MS.

According to Spherix, this delay in Celgene’s plans will open the door for two other DMT candidates to be launched on the market: Siponimod and EMD Serono‘s Mavenclad (cladribine), which was approved last year in the EU.

Interest has been building in the MS community for Siponimod mainly due to its safety and efficacy profile, and its potential SPMS indication, which could cover both active and nonactive forms of the disease.

Regarding Mavenclad, neurologists’ interest seem to be more divided, the Spherix report said.

“Mavenclad offers a high efficacy, infrequently dosed oral therapy with induction potential, but safety/tolerability concerns may be a barrier to use. It remains to be seen where Mavenclad will be used in the treatment algorithm, as U.S. neurologists tend to be more conservative than their EU counterparts,” Robert Naismith, an MS expert and adviser to Spherix Global Insights, said in a press release.