Ocrevus Still Top Therapy for Progressive MS Forms, Report Finds

Ocrevus (ocrelizumab) continues to be the most commonly prescribed therapy for progressive forms of multiple sclerosis (MS), including primary progressive MS (PPMS) and secondary progressive MS (SPMS), according to an analysis from the market intelligence firm Spherix Global Insights.

However, other therapies are “gaining traction” among SPMS patients, the report finds.

Most people who are diagnosed with MS will first be diagnosed with relapsing-remitting disease (RRMS), which is characterized by periods of worsening symptoms (relapses) followed by times when symptoms ease (remissions).

Over time, almost all people with RRMS will eventually progress to SPMS — when symptoms continually get worse over time. Some people with SPMS will continue to have disease remissions, which are termed “active” SPMS.

In PPMS, symptoms continually worsen over time from the onset of the first symptom, without an initial period of relapses and remission, but patients can also experience occasional relapses.

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The Spherix report assessed data on 758 people with PPMS or SPMS who were treated with disease-modifying therapies, collected by 148 neurologists in the U.S.

Results showed that Ocrevus continues to be the most commonly prescribed therapy for SPMS patients with relapses. However, newer medications — particularly the oral S1P receptor modulator Zeposia (ozanimod) and the under-the-skin anti-CD20 therapy Kesimpta (ofatumumab) — are being used more often, according to a press release.

Ocrevus, an anti-CD20 monoclonal antibody therapy made by Genentech (a member of the Roche Group), is the only approved treatment for PPMS. It continues to “dominate” across prescriptions for this type of MS, the report found.

“Ocrevus users have high satisfaction with most PPMS patients’ response to the DMT [disease-modifying therapy] and perceive it to have an extremely favorable risk/benefit profile — likely supporting continued use of this high-efficacy option,” the release states.

No therapies are approved to treat non-active SPMS, or SPMS without relapses. According to the Spherix report, data over the last four years suggest an increasing use of monoclonal antibody therapies like Ocrevus and of high-efficacy oral treatments, such as Zeposia and Mavenclad (cladribine).

The report also highlights two investigational MS therapies: tolebrutinib, being developed by Sanofi Genzyme, and fenebrutinib, being developed by Genentech. Both work by blocking the activity of Bruton’s tyrosine kinase (BTK), a protein thought to be involved in the inflammatory activity of immune cells that drive MS.

According to the report, tolebrutinib is noteworthy because it is the only therapy being tested in all types of progressive MS — including for non-active SPMS.

Meanwhile, fenebrutinib is being tested in trials directly against Ocrevus, allowing an opportunity to not just generate efficacy data on the investigational therapy, but to directly compare it with the industry leader.

“While Ocrevus will likely maintain its position as the leader in the [progressive MS] arena, successful clinical developments and an FDA nod for these novel DMTs, especially in not active SPMS and PPMS, will provide patients with much needed alternatives,” the release concludes.