Currently, the anti-CD20 monoclonal antibody ocrelizumab is the only approved treatment for primary progressive multiple sclerosis (PPMS). However, a new study suggests that other immunomodulatory disease-modifying therapies that are often used to treat relapsing forms of multiple sclerosis could be effective in people with PPMS who have evidence of active inflammatory disease.
This is a preview of subscription content, access via your institution
Access options
Access Nature and 54 other Nature Portfolio journals
Get Nature+, our best-value online-access subscription
$29.99 / 30 days
cancel any time
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Hauser, S. L. & Cree, B. A. C. Treatment of multiple sclerosis: a review. Am. J. Med. 133, 1380–1390.e2 (2020).
Montalban, X. et al. Ocrelizumab versus placebo in primary progressive multiple sclerosis. N. Engl. J. Med. 376, 209–220 (2017).
European Medicines Agency. Summary of Opinion EMA: Ocrevus (ocrelizumab) https://www.ema.europa.eu/en/medicines/human/EPAR/ocrevus (2017).
Portaccio, E. et al. Disease-modifying treatments and time to loss of ambulatory function in patients with primary progressive multiple sclerosis. JAMA Neurol. https://doi.org/10.1001/jamaneurol.2022.1929 (2022).
Brown, J. W. L. et al. Association of initial disease-modifying therapy with later conversion to secondary progressive multiple sclerosis. J. Am. Med. Assoc. 321, 175–187 (2019).
He, A. et al. Timing of high-efficacy therapy for multiple sclerosis: a retrospective observational cohort study. Lancet Neurol. 19, 307–316 (2020).
Lizak, N. et al. Association of sustained immunotherapy with disability outcomes in patients with active secondary progressive multiple sclerosis. JAMA Neurol. 77, 1398–1407 (2020).
Kappos, L. et al. Siponimod versus placebo in secondary progressive multiple sclerosis (EXPAND): a double-blind, randomised, phase 3 study. Lancet 391, 1263–1273 (2018).
Palladino, R., Marrie, R. A., Majeed, A. & Chataway, J. Evaluating the risk of macrovascular events and mortality among people with multiple sclerosis in England. JAMA Neurol. 77, 820–828 (2020).
Neumann, B. et al. Metformin restores CNS remyelination capacity by rejuvenating aged stem cells. Cell Stem Cell 25, 473–485.e8 (2019).
Acknowledgements
T.W. acknowledges support from the MS-STAT2 clinical trial (ClinicalTrials.gov NCT03387670), with funding derived from the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme, the UK Multiple Sclerosis Society, the US National Multiple Sclerosis Society and the Rosetrees Trust. J.C. acknowledges support from the Efficacy and Evaluation Programme, a Medical Research Council and NIHR partnership and the HTA Programme, the UK MS Society, the US National MS Society and the Rosetrees Trust. J.C. is supported in part by the NIHR University College London Hospitals Biomedical Research Centre, London, UK.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
T.W. has received honoraria for educational talks for Novartis and Merck. J.C. has been a local principal investigator for a trial in MS funded by the Canadian MS Society and for commercial trials funded by Actelion, Novartis and Roche. He has taken part in advisory boards and/or consultancy for Azadyne, Janssen, Merck, NervGen, Novartis and Roche.
Rights and permissions
About this article
Cite this article
Williams, T., Chataway, J. Beyond ocrelizumab in primary progressive multiple sclerosis. Nat Rev Neurol 18, 641–642 (2022). https://doi.org/10.1038/s41582-022-00724-8
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41582-022-00724-8