New real-world study supports long-term Ocrevus use in relapsing MS
Four-year registry data show low relapse rates and high persistence
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A patient is being comforted by a doctor. (Photo from iStock)
- Ocrevus shows sustained effectiveness for relapsing multiple sclerosis, with low relapse rates and reduced disability worsening.
- Most patients on Ocrevus remained free from long-term disability worsening and had low relapse rates over four years.
- Ocrevus was generally well tolerated, with more favorable outcomes when started early in the multiple sclerosis disease course.
In real-world clinical practice, Ocrevus (ocrelizumab) showed sustained effectiveness in people with relapsing forms of multiple sclerosis (MS), with most patients remaining free from long-term worsening of disability over four years, according to a new study.
Relapse rates and MRI disease activity were also low during follow-up. At four years, 39.7% of patients with available MRI data achieved no evidence of disease activity, defined as no relapses, no new MRI activity, and no confirmed worsening of disability.
The findings provide “strong evidence on the effectiveness and clinical benefit of [Ocrevus],” the researchers wrote in “Real-world effectiveness of ocrelizumab in relapsing multiple sclerosis: An MSBase registry sub-study,” published in Multiple Sclerosis and Related Disorders.
Why real-world studies matter in MS
MS is a long-term disease in which the immune system mistakenly attacks the protective covering of nerve cells in the brain and spinal cord. This can cause a range of symptoms, including problems with movement, vision, and sensation.
Marketed by Genentech, a Roche company, Ocrevus is an infusion treatment approved for use in both primary progressive MS and relapsing forms of MS, including clinically isolated syndrome, relapsing-remitting MS, and active secondary progressive MS.
While Ocrevus has been shown to be effective in clinical trials, these well-controlled studies are often restricted to specific patient groups, and results may not fully represent the broader MS population. Real-world studies that include more representative populations and follow patients for longer periods can help address those limitations.
MSOCR-R, funded by Roche, is an ongoing study that aims to evaluate how well Ocrevus works over the long term when used in clinical practice. It is based on data from the MSBase international registry.
Study tracks more than 1,000 patients across 10 countries
A total of 1,011 patients from 10 countries were included. Most patients (81.9%) switched from another disease-modifying treatment to Ocrevus, whereas 18.1% started Ocrevus as their first treatment for MS. About two-thirds (67.1%) were women. At the start of treatment with Ocrevus, the mean age was 41.9 years, and patients had lived with MS for a median of 10.4 years.
Participants received Ocrevus for a median of 3.4 years, with most (79%) remaining on the therapy for at least two years.
Results showed that the annualized relapse rate, the average number of relapses per year, decreased from 0.58 before treatment to 0.05 after starting Ocrevus. A small proportion of patients (13.3%) experienced one or more relapses while on treatment.
Disability was measured using the Expanded Disability Status Scale (EDSS), where higher scores indicate more severe disability. At four years, most patients (74.8%) remained free of confirmed disability worsening, defined as a sustained increase in disability lasting at least 24 weeks.
The researchers also measured progression independent of relapse activity (PIRA), which refers to disability worsening in the absence of a relapse. At four years, about 78% of patients remained free of PIRA.
At four years, the probability of achieving no evidence of disease activity was 39.7% among patients with available MRI data.
High treatment persistence over four years
Most patients were still on Ocrevus at two years (98.2%) and four years (88%). Among patients who discontinued treatment, the most common reasons were side effects, disease activity or lack of improvement, lack of compliance or convenience, and family planning.
Still, side effects accounted for less than 20% of reasons for treatment discontinuation, based on reported reasons for stopping therapy, suggesting Ocrevus was generally well tolerated in this real-world setting.
Using highly effective treatments that patients can stay on, and that are well tolerated, “is critical to achieving best clinical outcomes and therapeutic benefit for patients,” the researchers wrote.
Overall, the researchers also found that outcomes were more favorable among patients who started Ocrevus as their first treatment, supporting its use early in the disease course.
“This study will continue to expand in numbers of patients and follow-up,” the researchers wrote. “Together with the post-marketing safety studies, these data will inform best strategies for effective and safe long-term [Ocrevus] use.”
