Early use of Ocrevus (ocrelizumab) significantly slows shrinkage of the thalamus — a brain region involved in sensory and motor functions — in people with relapsing forms of multiple sclerosis (MS) and primary progressive MS (PPMS), according to new analyses from three Phase 3 trials that compared immediate use with a two-year delay.
These data also suggested that initial (baseline) thalamic volume may be used as a predictor of disability progression in relapsing MS patients.
Findings were presented by Douglas Arnold, MD, with McGill University’s Montreal Neurological Institute and Hospital, in Canada, at the MSVirtual2020 that ran Sept. 11–13. It marked the 8th joint meeting of the American (ACTRIMS) and European (ECTRIMS) Committees for Treatment and Research in MS.
Arnold is also president and CEO of NeuroRx Research, a company focused on advanced image analysis techniques of the central nervous system (the brain and spinal cord) to provide outcome data.
His oral presentation was titled “Reduced thalamic atrophy in patients initiating earlier versus delayed ocrelizumab therapy: results from the OLE of OPERA I/II and ORATORIO” (abstract # FC03.05).
The thalamus is a brain structure that not only serves as a kind of relay and integration center for sensory information other than smell, but also is involved in motor control, alertness, memory, and cognition.
In MS patients, thalamic shrinkage, or atrophy, occurs early and consistently over the course of the disease. Its integrity is affected both directly by neuronal death, and indirectly by lesions in other brain areas that connect with the thalamus.
“Pathological studies have revealed a loss of up to one-third of neurons in the thalamus” of MS patients, Arnold said.
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