New biologic treatment for MS promises to improve patients’ QOL

Ocrelizumab, a humanized anti-CD20 monoclonal antibody, is now available in Malaysia. The molecule is indicated for the treatment of relapsing forms of multiple sclerosis (RMS) and primary progressive multiple sclerosis (PPMS). It targets CD20 marker on B lymphocytes and is an immunosuppressive drug.

The therapeutic effectiveness of ocrelizumab in managing RMS was demonstrated by two studies, OPERA I and OPERA II, which involved 1,656 participants over a duration of 96 weeks. In those studies, patients administered ocrelizumab experienced nearly halved (46 percent) relapse rates.[N Engl J Med 2017;376:221-234]

Additionally, ocrelizumab has been shown to effectively slow disability progression, with participants being 40 percent less likely to experience this outcome, while a smaller proportion (9.8 percent) witnessed progression of disability. A significant number of individuals (33 percent) demonstrated improvement in disability status after 3 months of treatment with ocrelizumab. The medication has also been validated in reducing the formation of brain lesions.

Both OPERA studies documented a pronounced decrease in MRI-detected lesions, with reduction rates of 94 and 95 percent, respectively. In the ORATORIO trial, which focused on PPMS in 732 participants treated for a minimum of 120 weeks, ocrelizumab significantly postponed disability progression, with a 24 percent decrease in the likelihood of progression observed. [N Engl J Med 2017; 376:209-220]

For more detailed information on ocrelizumab, parties are encouraged to consult their neurologist or physician.

MS at a glance
Multiple sclerosis (MS) is a neurological disorder that impacts the central nervous system, which includes the brain and spinal cord, and plays a crucial role in controlling all body functions. MS causes damage to the myelin sheath. The degradation of myelin, or demyelination, hinders the nerves’ capacity to transmit electrical signals to and from the brain.

Consequently, individuals with MS may exhibit a wide array of symptoms, which vary greatly from one person to another and can range from mild to severe. These symptoms may encompass blurred vision, dizziness, fatigue, numbness, tingling, muscle spasms, stiffness, weakness in the limbs, problems with mobility, speech issues, vertigo, pain, and difficulties with bowel or bladder control and swallowing. As of 2020, around 2.8 million people globally were living with MS, which represents about 1-in-3,000 persons. The condition is more prevalent in North America, Europe, and certain areas of Australia, where up to 1-in-300 people may have MS. [Available at Atlas of MS 3rd edition. https://www.msif.org/wp-content/uploads/2020/10/Atlas-3rd-Edition-Epidemiology-report-EN-updated-30-9-20.pdf  Accessed on 14 March 2024]

Despite having a lower prevalence in Asia, MS patients there still experience severe symptoms on par with those in Western nations. In Malaysia, MS is considered a rare condition, with an estimated prevalence of 6 cases per 100,000 individuals. [Available at Atlas of MS. https://www.atlasofms.org/map/malaysia/epidemiology/number-of-people-with-ms Accessed on 14 March 2024]

OPERA: A Study of Ocrelizumab in Comparison With Interferon Beta-1a (Rebif) in Participants With Relapsing Multiple Sclerosis (Note: Both Opera I and Opera II were identical phase 3 trials, hence the same name.) 

ORATORIO: A Study of Ocrelizumab in Participants With Primary Progressive Multiple Sclerosis