MS news notes: Ocrevus injection, Tysabri scheduling, OCH for SPMS

Welcome to “MS News Notes,” a column where I comment on multiple sclerosis (MS) news stories that caught my eye last week. This week, the stories cover research presented at the joint meeting of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) and the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS), held last week in Milan, Italy.

A thumbs-up for Ocrevus by injection

Ocrevus (ocrelizumab) is a high-efficacy disease-modifying therapy (DMT) that is dispensed every six months by infusion. The MS News Today story titled “ECTRIMS 2023: Under-the-skin Ocrevus found to be powerful in MS” indicates that another route of administration is likely just as effective as the infusion.

Most participants in a Phase 3 clinical trial experienced “drastic reductions in B-cells within a couple of weeks,” whether they received Ocrevus via an infusion or the newer method, subcutaneous injection. Most of them had no relapses or new MRI activity over the six months of the trial.

Although nearly half of those given the shot during the trial experienced mild injection-related reactions, the choice between a 10-minute injection or a two-hour infusion with the same results seems like a no-brainer to me. It’ll save both patients and doctors time.

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Individualized Tysabri treatment schedules

When I was being treated with Tysabri (natalizumab), I initially received an infusion once a month. When the level of John Cunningham virus in my blood rose to a point that prompted concerns about my susceptibility to a brain disease called progressive multifocal leukoencephalopathy (PML), my neurologist reduced my treatment schedule from every four weeks to every eight weeks. She told me that the medication would be just as effective, but less risky, at the reduced dosing schedule.

That was many years ago. Now, as “ECTRIMS 2023: Personalized dosing of Tysabri shows good efficacy” reports, it appears that my doctor was doing the right thing.

Researchers in the NEXT-MS clinical trial split participants into three groups that received Tysabri either according to the regular dosing schedule, or when levels of Tysabri in the blood declined to either 10 micrograms (mcg)/mL or 5 mcg/mL. Most participants were then followed for more than a year. For the latter two groups, the median time between infusions increased. In both of those groups, levels of a nerve damage marker called neurofilament light chain were stable over the course of the study. This means that extended treatment intervals appear to be safe and effective.

To me, all of this means that more personalized treatment schedules with Tysabri are yet another no-brainer.

Promising results for SPMS patients treated with OCH

OCH is an experimental, oral medication that uses a unique method of controlling MS progression. It does so by modifying T-cells to boost their anti-inflammatory function, as we learn in the story “ECTRIMS 2023: Treating SPMS with OCH shows promise in small study.”

This is only a very small study, but five of the six people with secondary progressive MS (SPMS) who received OCH showed no evidence of disease activity (NEDA) after six months. None of six other patients, all of whom received a placebo, achieved NEDA.

Since only one DMT, mitoxantrone, is approved in the U.S. to treat nonactive SPMS — which is my diagnosis — I think a lot of us will be keeping an eye on studies of OCH, with the hope that it can be added to the treatment list one of these days.

Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to multiple sclerosis.