MS Wrap-up: Pregnant Women With MS, ORATORIO Trial Results, and More

Here are some of the latest developments in multiple sclerosis (MS) from our sister publication, NeurologyLive®.

Prepregnancy Disease Relapse Linked to Worsened Long-term Disability

A greater risk of worsened long-term disability was seen among women who became pregnant in the year following a multiple sclerosis (MS) disease relapse, reports NeurologyLive®.

Results from the Italian Pregnancy Dataset of the 2 study cohorts (n = 230 in the pregnant plus MS group; n = 102 in the pregnant minus MS group) show that 28.3% in the MS group and 21.6% in the non-MS group had worsening disease progression over a mean (SD) of 6.5 (3.1) years of follow-up (P = .201). Disease progression risk also was elevated 74% if a woman had a MS relapse in the 12 months leading up to pregnancy (adjusted HR [aHR], 1.75; 95% CI, 1.06-2.84; P = .027).

Additional factors related to disease worsening were higher Expanded Disability Status Scale score at baseline (aHR, 1.39; 95% CI, 1.12-1.74; P = .003), younger age (aHR, 0.95; 95% CI, 0.91-0.99; P = .022), and reduced disease-modifying therapy during follow-up (P < .008).

Read the entire article here.

ORATORIO Trial Findings Validate aT2-LV as a Biomarker in PPMS

Atrophied T2-lesion volume (aT2-LV) accumulation in patients randomized 2:1 to receive placebo (n = 244) vs ocrelizumab (n = 488) add heft to previous study findings showing the biomarker has accuracy when used to gauge disability level in persons with primary progressive MS (PPMS).

In an interview with NeurologyLive®, lead study investigator Robert Zivadinov, MD, PhD, professor of neurology and director, Translational Imaging Center, Clinical Translational Research Center, Buffalo Neuroimaging Analysis Center, detailed the differences seen between the groups over 2 years. Ocrelizumab resulted in aT2-LV accumulation of 319 mm³ vs 366 mm³ seen with placebo.

Zivadinov also explained that immunological or immunity-related causes may be to blame for the loss in brain volume, in that disappearing lesions may be driven by microglial activation within them, which accelerates their loss.

Read the entire interview here.

Ublituximab Shown Superior to Teriflunomide in Relapsing MS

Data from a pair of studies presented at the 7th Congress of the European Academy of Neurology, held June 19-22, demonstrate the efficacy and safety of ublituximab, an investigational glycoengineered anti-CD20 monoclonal antibody, over teriflunomide, a pyrimidine synthesis inhibitor, among persons with relapsing MS.

Following a 1-hour, 450-mg infusion of ublituximab every 6 months for 96 weeks after a day 1 infusion of 150 mg over 4 hours, in the ULTIMATE 1 trial, the annualized relapse rate (ARR) was 0.076 vs 0.188 seen with teriflunomide, for a relative reduction of 60% (ARR ratio, 0.406; 95% CI, 0.268-0.615; P < .0001). ULTIMATE 2 saw ARRs of 0.091 for ublituximab and 0.178 for teriflunomide, for a 49% relative reduction (ARR ratio, 0.509; 95% CI, 0.330-0.784; P = .0022).

Compared with teriflunomide, total T1 gadolinium–enhancing lesions and new or enlarging T2 lesions, respectively, were also reduced in the ublituximab group in ULTIMATE 1 by 97% and 96% and in ULTIMATE 2 by 92% and 90%.

Read the entire article here.