Ocrelizumab versus Placebo in Primary Progressive Multiple Sclerosis

Patients with primary progressive MS who received the anti-CD20+ humanized antibody ocrelizumab were less likely to have clinical deterioration that was sustained for 12 weeks than those who received placebo. The drug was associated with decreased lesion activity on MRI. Primary progressive multiple sclerosis accounts for 10 to 15% of the overall population with multiple sclerosis. 1 The course of this disease differs from those of relapsing–remitting and secondary progressive forms of multiple sclerosis in that progression consists mainly of gradual worsening of neurologic disability from symptom onset, although relapses may occur. 1 Phase 3 trials in primary progressive multiple sclerosis have been unsuccessful, 2 – 4 and no disease-modifying treatments have been approved. B cells contribute to the pathogenesis of multiple sclerosis, including the primary progressive form. 5 Although the mechanisms of tissue injury in multiple sclerosis are uncertain, B cells may influence pathogenesis . . .