Ocrelizumab (Ocrevus®) treatment led to high rates of “no evidence of disease activity” (NEDA) in patients with multiple sclerosis (MS), found a new study published in the European Journal of Neurology.
These are findings from a prospective, multicenter, open-label, phase 3b clinical trial called CASTING that aimed to assess the safety and efficacy of ocrelizumab in patients with relapsing-remitting MS who have had a suboptimal response to a previous disease-modifying treatment.
This was the case across demographic subgroups and regardless of prior treatment background. There were no new safety signals detected.
“This study highlights the importance of recognizing breakthrough disease and the value of reacting with a treatment switch to ocrelizumab in order to maintain disease control and optimize short- and long-term patient outcomes,” Patrick Vermersch MD, PhD, professor of neurology at Lille University in France, and the coauthors of the study wrote.
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The primary outcome measure of the trial was the percentage of participants with NEDA, which is a new goal emerging in MS treatment. Also known as freedom from disease activity, NEDA is defined as the absence of relapses, disability progression, and inflammatory magnetic resonance imaging (MRI) measures, with prespecified MRI rebaselining at week 8.
A total of 680 participants with an Expanded Disability Status Scale (EDSS) score of 4 or lower were enrolled in the study. They received 600 mg of ocrelizumab intravenously every 24 weeks for 96 weeks.
At week 96, the majority (74.8%) of patients had NEDA. This was highest among patients who were enrolled because of MRI activity alone. When assessed among subgroups, NEDA was highest among patients who had a baseline EDSS score of less than 2.5 and those receiving 1 prior disease-modifying treatment.
Vermersch P, Oreja-Guevara C, Siva A, CASTING investigators. Efficacy and safety of ocrelizumab in patients with relapsing-remitting multiple sclerosis with suboptimal response to prior disease-modifying therapies: primary analysis from the phase 3b CASTING single-arm, open-label trial. Eur J Neurol. Published online November 8, 2021. doi:10.1111/ene.15171