“Landmark” drug is first to work in primary progressive multiple sclerosis

December 23, 2016

A “landmark” drug that alters the human immune system to treat multiple sclerosis (MS) has been found to be the first drug shown to work in the primary progressive form of the disease in trials.

The drug, called ocrelizumab, is being reviewed for use in the US and Europe.

MS is caused by a rogue immune system mistaking part of the brain for a hostile invader and attacking it. The diseasedestroys the protective coating called the myelin sheath, which wraps round nerves.

The sheath also acts like wire insulation to help electrical signals travel down the nerve.

Damage to the sheath prevents nerves from working correctly and means messages struggle to get from the brain to the body.This leads to symptoms like having difficulty walking, fatigue and blurred vision.

The disease can either just get worse, known as primary progressive MS, or come in waves of disease and recovery, known as relapsing remitting MS.Both are incurable, although there are treatments for the second state.

Ocrelizumab kills a part of the immune system – called B cells – which are involved in the assault on the myelin sheath.

In 732 patients with progressive MS, the percentage of patients that had deteriorated fell from 39% without treatment to 33% with ocrelizumab.Patients taking the drug also scored better on the time needed to walk 25 feet and had less brain loss detected on scans.

In 1,656 patients with relapsing remitting, the relapse rate with ocrelizumab was half that of using another drug.

Prof. Gavin Giovannoni, from Barts and The London School of Medicine and Dentistry and who was involved in the trials, said that the trial results show potential in changing how relapsing and primary progressive MS are treated.

In an interview, he said that the findings are significant because it marks the first time a phase three trial has shown positive results in primary progressive MS.

More than 100,000 people are diagnosed with MS in the UK, around one-in-five are progressive.

Dr. Aisling McMahon, the head of clinical trials at the MS Society, commented that the positive result is big news for those with the primary progressive form of multiple sclerosis as this is the first time that a treatment has shown the potential to reduce disability progression for the specific type, offering hope for the future.

The drug is being considered by the European Medicines Agency and the US Food and Drug Administration.

But Giovannoni warned that patients in the UK may be disappointed as it may be hard for the NHS to fund everyone getting a drug that is likely to be expensive, saying that he expects only a narrow group of people to be eligible.

 

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Category: Features, Pharmaceuticals

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