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BREAKING: Ocrelizumab first drug to show positive results in progressive MS

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  • BREAKING: Ocrelizumab first drug to show positive results in progressive MS

    SCROLL TO BOTTOM POSTS FOR LATEST NEWS. Finally, some potentially stellar news for folks with progressive MS. Although this study looked at RRMS and PPMS, it stands to reason that SPMS would benefit as well. Stoked it could be on the market in 2016. NOTE: I am slated to interview folks about this treatment in the coming weeks if you guys have specific questions you'd like me to ask. - Dave

    GENENTECH’S OCRELIZUMAB FIRST INVESTIGATIONAL MEDICINE TO SHOW EFFICACY IN PEOPLE WITH PRIMARY PROGRESSIVE MULTIPLE SCLEROSIS IN LARGE PHASE III STUDY

    Ocrelizumab is the first investigational medicine to show positive study results in both primary progressive and relapsing forms of multiple sclerosis

    Genentech will submit data to the U.S. Food and Drug Administration for both forms of multiple sclerosis in early 2016

    SOUTH SAN FRANCISCO, Calif.--(BUSINESS WIRE)--Genentech, a member of the Roche Group (SIX: RO, ROG; OTCQX: RHHBY), today announced positive results from a pivotal Phase III study that evaluated the investigational medicine ocrelizumab in people with primary progressive multiple sclerosis (PPMS). The study (called ORATORIO) met its primary endpoint, showing treatment with ocrelizumab significantly reduced the progression of clinical disability sustained for at least 12 weeks compared with placebo, as measured by the Expanded Disability Status Scale (EDSS).

    “People with the primary progressive form of MS typically experience symptoms that continuously worsen after the onset of their disease, and there are no approved treatments for this debilitating condition”

    Overall, the incidence of adverse events associated with ocrelizumab was similar to placebo; the most common adverse events were mild-to-moderate infusion-related reactions. The incidence of serious adverse events associated with ocrelizumab, including serious infections, was also similar to placebo.

    “People with the primary progressive form of MS typically experience symptoms that continuously worsen after the onset of their disease, and there are no approved treatments for this debilitating condition," said Sandra Horning, M.D., chief medical officer and head of Global Product Development. “Ocrelizumab is the first investigational medicine to show a clinically meaningful and statistically significant effect on the progression of disease in primary progressive MS.”

    The positive study results observed with ocrelizumab in both people with PPMS (ORATORIO) as well as those with relapsing forms of MS (OPERA I and OPERA II) validate the hypothesis that B cells are central to the underlying biology of the disease.

    Top-line data from the ORATORIO study will be presented as a late-breaking abstract at the 31st congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) by Xavier Montalban, M.D., Ph.D., chair of the Scientific Steering Committee of the ORATORIO study and professor of Neurology and Neuroimmunology at Vall d’Hebron University Hospital and Research Institute, Barcelona, Spain on Saturday, October 10th (Abstract #228, 8:52 - 9:03 am CET) in Barcelona, Spain.

    Additionally, Phase III results in people with relapsing MS (OPERA I and OPERA II studies) will be presented at ECTRIMS by Stephen Hauser, M.D., chair of the Scientific Steering Committee of the OPERA studies and chair of the Department of Neurology at the University of California San Francisco School of Medicine on Friday, October 9th (Abstract #190, 14:40 - 14:52 pm CET).

    Genentech plans to pursue marketing authorization for ocrelizumab in relapsing MS and in PPMS. Data from the OPERA I and II studies and from the ORATORIO study will be submitted to the U.S. Food and Drug Administration in early 2016.

    About the ORATORIO study

    ORATORIO is a Phase III, randomized, double-blind, global multi-center study evaluating the efficacy and safety of ocrelizumab (600 mg administered by intravenous infusion every six months; given as two 300 mg infusions two weeks apart) compared with placebo in 732 people with PPMS.i The primary endpoint of the ORATORIO study was time to onset of confirmed disability progression (CDP), defined as an increase in EDSS that is sustained for at least 12 weeks.

    About ocrelizumab

    Ocrelizumab is an investigational, humanized monoclonal antibody designed to selectively target CD20-positive B cells. CD20-positive B cells are a specific type of immune cell thought to be a key contributor to myelin (nerve cell insulation and support) and axonal (nerve cell) damage, which can result in disability in people with MS. Based on preclinical studies, ocrelizumab binds to CD20 cell surface proteins expressed on certain B cells, but not on stem cells or plasma cells, and therefore important functions of the immune system may be preserved.

    In addition to ORATORIO, the Phase III clinical development program for ocrelizumab includes OPERA I and OPERA II, which are randomized, double-blind, double-dummy, global multi-center studies in people with relapsing forms of MS.ii,ii

    About multiple sclerosis

    Multiple sclerosis (MS) is a chronic disease that affects an estimated 2.3 million people around the world, for which there is currently no cure.iii,iv MS occurs when the immune system abnormally attacks the insulation and support around the nerve cells (myelin sheath) in the brain, spinal cord and optic nerves, causing inflammation and consequent damage.v,vi Damage to these nerve cells can cause a wide range of symptoms, including muscle weakness, fatigue and difficulty seeing, and may eventually lead to disability.iv Most people with MS experience their first symptom between 20 and 40 years of age, making the disease the leading cause of non-traumatic disability in younger adults.vii,viii

    Relapsing MS is the most common form of the disease. Disease activity and progression can occur even when people do not show signs or symptoms of MS, despite available relapsing MS treatments. Primary progressive MS (PPMS) is a debilitating form of the disease marked by steadily worsening symptoms but typically without distinct relapses (periods of time when symptoms flare) or periods of remission.ix Approximately one in 10 people with MS are diagnosed with the primary progressive form of the disease. There are no approved treatments for PPMS.

    About Genentech in Neuroscience

    Neuroscience is a major focus of research and development at Genentech and Roche. The company’s goal is to develop treatment options based on the biology of the nervous system to help improve the lives of people with chronic and potentially devastating diseases. Our neuroscience research and development program includes more than a dozen investigational medicines in clinical development for diseases that include multiple sclerosis, Alzheimer’s disease, spinal muscular atrophy, Parkinson’s disease, Down syndrome and autism.

    About Genentech

    Founded more than 35 years ago, Genentech is a leading biotechnology company that discovers, develops, manufactures and commercializes medicines to treat patients with serious or life-threatening medical conditions. The company, a member of the Roche Group, has headquarters in South San Francisco, California. For additional information about the company, please visit http://www.gene.com.

    References

    iF. Hoffmann-La Roche. ClinicalTrials.gov NCT01194570. National Library of Medicine. Available at: https://clinicaltrials.gov/ct2/show/NCT01194570.

    iiF. Hoffmann-La Roche. ClinicalTrials.gov NCT01247324 and NCT01412333. National Library of Medicine. Available at: https://clinicaltrials.gov/ct2/show/NCT01247324 and https://clinicaltrials.gov/ct2/show/NCT01412333.

    iiiMultiple Sclerosis International Federation. (2013). Atlas of MS 2013. Available at: http://www.msif.org/about-us/advocacy/atlas/.

    ivNational Institutes of Health-National Institute of Neurological Disorders and Stroke. (2015). Multiple Sclerosis: Hope Through Research. Available at: http://www.ninds.nih.gov/disorders/m....htm#280373215.

    vConstant SL. (1999). B lymphocytes as antigen-presenting cells for CD4+ T cell priming in vivo. J Immunol, 162(10):5695-5703.

    viCrawford A, et al. (2006). Primary T cell expansion and differentiation in vivo requires antigen presentation by B cells. J Immunol, 176(6):3498-3506.

    viiMurray TJ. (2006). Diagnosis and treatment of multiple sclerosis. BMJ, 322 (7540):525-527.

    viiiMS International Federation. What is MS? Available at http://www.msif.org/about-ms/what-is-ms/.

    ixMS International Federation. Types of MS. Available at: http://www.msif.org/about-ms/types-of-ms/
    Dave Bexfield
    ActiveMSers

  • #2
    GENENTECH’S OCRELIZUMAB FIRST INVESTIGATIONAL MEDICINE TO SHOW POSITIVE PIVOTAL STUDY RESULTS IN BOTH RELAPSING AND PRIMARY PROGRESSIVE FORMS OF MULTIPLE SCLEROSIS


    · Ocrelizumab showed superiority to interferon beta-1a (Rebif®) in two identical Phase III studies in people with relapsing multiple sclerosis (MS), the most common form of the disease

    · Ocrelizumab is the first investigational medicine to show efficacy in people with primary progressive MS in a large Phase III study

    · Ocrelizumab Phase III data will be presented at the 31st congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) from October 7-10 in Barcelona, Spain

    SOUTH SAN FRANCISCO, Calif. -- October 8, 2015 -- Genentech, a member of the Roche group (SIX: RO, ROG; OTCQX: RHHBY) today announced data from three positive, pivotal Phase III studies of ocrelizumab in people with relapsing multiple sclerosis (MS) and primary progressive multiple sclerosis (PPMS). Data from two identical studies (called OPERA I and OPERA II) in people with relapsing MS, which affects approximately 85 percent of people with MS at the time of diagnosis, showed ocrelizumab was superior to interferon beta-1a (Rebif®), a well-established MS therapy, in reducing the three major markers of disease activity over the two-year controlled treatment period.

    In a separate study (called ORATORIO) in people with PPMS, a form of the disease marked by steadily worsening symptoms and typically without distinct relapses or periods of remission, ocrelizumab significantly reduced the progression of clinical disability sustained for at least 12 weeks (the primary endpoint) and 24 weeks (a secondary endpoint) compared with placebo. Additionally, the study met other secondary endpoints of reducing the time required to walk 25 feet, the volume of chronic inflammatory brain lesions, and brain volume loss.

    “The results of these three pivotal trials have the potential to transform the treatment of MS,” said Sandra Horning, M.D., chief medical officer and head of Global Product Development. “Ocrelizumab is the first investigational medicine to significantly reduce disability progression in people with relapsing MS and people with primary progressive MS – a form of MS with no approved treatments. We are eager to work with regulatory authorities to bring this investigational medicine to the MS community as soon as possible.”

    “These results redefine our understanding of MS by highlighting the central role of the B cell,” said Stephen Hauser, M.D., chair of the Scientific Steering Committee of the OPERA studies and chair of the Department of Neurology at the University of California San Francisco School of Medicine. “The findings may also encourage the MS community to look more closely at earlier treatment of the disease. Currently, many doctors reserve what are considered highly effective MS medicines until a patient’s disease becomes more advanced. Patients and their doctors need new treatment options that offer the potential for greater efficacy than a standard-of-care interferon with a similar safety profile.”

    “This is an important moment for the MS community,” said Xavier Montalban, M.D., Ph.D., chair of the Scientific Steering Committee of the ORATORIO study and professor of Neurology and Neuroimmunology at Vall d’Hebron University Hospital and Research Institute, Barcelona, Spain. “For decades, trial after trial has failed to show the benefit of any medicine for people with primary progressive MS. Now, for the first time, we have a positive Phase III study result for people with this debilitating form of the disease.”

    Genentech plans to pursue marketing authorization for ocrelizumab in relapsing MS and in PPMS. Data from the ocrelizumab OPERA I and OPERA II studies and from the ORATORIO study will be submitted to the U.S. Food and Drug Administration in early 2016.

    About the OPERA I and OPERA II studies in relapsing MS

    Results from the OPERA I and OPERA II studies will be presented by Dr. Hauser on Friday, October 9 (Abstract #246, 2:40-2:52 PM CET). OPERA I and OPERA II are Phase III, randomized, double-blind, double-dummy, global multi-center studies evaluating the efficacy and safety of ocrelizumab (600 mg administered by intravenous infusion every six months) compared with interferon beta-1a (44 mcg administered by subcutaneous injection three times per week) in 1,656 people with relapsing forms of MS (i.e., relapsing-remitting MS and secondary-progressive MS with relapses).[i]

    In the OPERA I and OPERA II studies, ocrelizumab significantly reduced the annualized relapse rate (ARR) – the primary endpoint of both studies – by nearly 50 percent compared with interferon beta-1a over the two-year period. Additionally, ocrelizumab met secondary endpoints of the study, significantly delaying confirmed disability progression (CDP; loss of physical abilities, measured by the Expanded Disability Status Scale, or EDSS) by approximately 40 percent sustained for both 12 and 24 weeks compared with interferon beta-1a in pre-specified, pooled analyses of the two studies (p=0.0006 and p=0.0025, respectively). Ocrelizumab also significantly reduced acute MS-related inflammation and brain injury (total number of T1-gadolinium-enhancing lesions measured by magnetic resonance imaging, or MRI) at 24, 48 and 96 weeks by more than 90 percent and the emergence of more chronic or growing areas of MS-related brain injury (T2 hyperintense lesions) at 24, 48 and 96 weeks by around 80 percent compared with interferon beta-1a.

    Data from the Phase III studies in patients with relapsing MS showed:

    · A 46-percent and 47-percent reduction in the ARR compared with interferon beta-1a over the two-year period in OPERA I and OPERA II, respectively (p<0.0001 and p<0.0001).

    · A 43-percent and 37-percent risk reduction in CDP sustained for 12 weeks compared with interferon beta-1a in OPERA I and OPERA II, respectively (p=0.0139 and p=0.0169).

    · A 43-percent and 37-percent risk reduction in CDP sustained for 24 weeks compared with interferon beta-1a in OPERA I and OPERA II, respectively (p=0.0278 and p=0.0370).

    · A 94-percent and 95-percent reduction in the total number of T1 gadolinium-enhancing lesions compared with interferon beta-1a in OPERA I and OPERA II, respectively (p<0.0001 and p<0.0001).

    · A 77-percent and 83-percent reduction in the total number of new and/or enlarging hyperintense T2 lesions compared with interferon beta-1a in OPERA I and OPERA II, respectively (p<0.0001 and p<0.0001).

    Overall, the proportion of patients in the ocrelizumab group with adverse events was similar to interferon beta-1a in a pooled analysis of both studies (83.3 percent in each treatment group); the most common adverse event associated with ocrelizumab was infusion-related reactions (34.3 percent of patients who received ocrelizumab experienced at least one infusion-related reaction vs. 9.7 percent for interferon beta-1a). The proportion of patients in the ocrelizumab group with serious adverse events, including serious infections, was also similar to interferon beta-1a (6.9 percent vs. 8.7 percent, respectively).

    About the ORATORIO study in PPMS

    Results from the ORATORIO study will be presented as a late-breaking abstract by Professor Montalban on Saturday, October 10 (Abstract #2368, 8:52-9:03 AM CET). ORATORIO is a Phase III, randomized, double-blind, global multi-center study evaluating the efficacy and safety of ocrelizumab (600 mg administered by intravenous infusion every six months; given as two 300 mg infusions two weeks apart) compared with placebo in 732 people with PPMS.[ii] In contrast to the OPERA I and OPERA II studies, where the blinded treatment period was two years, the blinded treatment period of the ORATORIO study continued beyond that until all patients had received at least 120 weeks of either ocrelizumab or placebo and a predefined number of CDP events was reached overall in the study.

    The ORATORIO study met its primary endpoint, showing treatment with ocrelizumab significantly reduced the risk of progression of clinical disability sustained for at least 12 weeks by 24 percent compared with placebo, as measured by the EDSS (p=0.0321). Additionally, ocrelizumab was superior to placebo in significantly reducing the risk of progression of clinical disability for at least 24 weeks by 25 percent (p=0.0365) and the time required to walk 25 feet (Timed 25-Foot Walk, or T25-FW) over 120 weeks by 29 percent (p=0.0404). Ocrelizumab decreased the volume of hyperintense T2 lesions by 3.4 percent over 120 weeks, compared to placebo which increased T2 volume by 7.4 percent (p<0.0001). Ocrelizumab reduced the rate of whole brain volume loss over 120 weeks by 17.5 percent compared to placebo (p=0.0206).

    Overall, the proportion of patients in the ocrelizumab group with adverse events was similar to placebo (95.1 percent vs. 90.0 percent, respectively); the most common adverse event associated with ocrelizumab was infusion-related reactions (39.9 percent vs. 25.5 percent for placebo). The proportion of patients in the ocrelizumab group with serious adverse events, including serious infections, was also similar to placebo (20.4 percent vs. 22.2 percent, respectively).

    Ocrelizumab is an investigational, humanized monoclonal antibody designed to selectively target CD20-positive B cells. CD20-positive B cells are a specific type of immune cell thought to be a key contributor to myelin (nerve cell insulation and support) and axonal (nerve cell) damage, which can result in disability in people with MS. Based on preclinical studies, ocrelizumab binds to CD20 cell surface proteins expressed on certain B cells, but not on stem cells or plasma cells, and therefore important functions of the immune system may be preserved.
    Dave Bexfield
    ActiveMSers

    Comment


    • #3
      This drug was set to be approved by the FDA by the end of the month, but there is now a 3-month extension. Grr. - D

      The U.S. Food and Drug Administration (FDA) has extended its review of Roche's multiple sclerosis (MS) drug Ocrevus by three months to March 28, the Swiss drugmaker said on Tuesday.

      Roche is counting on Ocrevus becoming a mainstay treatment for patients suffering from the neurological disease to help bolster its revenue as other top selling drugs in its portfolio start to face competition from cheaper copies.

      "The extension is the result of the submission of additional data by Roche regarding the commercial manufacturing process of Ocrevus, which required additional time for FDA review. The extension is not related to the efficacy or safety of Ocrevus," Roche said in a statement.

      http://www.reuters.com/article/us-ro...-idUSKBN14922G
      Dave Bexfield
      ActiveMSers

      Comment


      • #4
        Here is the latest report from The New England Journal of Medicine. "This is the first drug to show a significant effect in slowing disability progression in a phase 3 trial in primary progressive multiple sclerosis, and therefore the trial represents a landmark study in the field." Heady stuff. - D

        http://www.nejm.org/doi/full/10.1056/NEJMe1614717
        Dave Bexfield
        ActiveMSers

        Comment


        • #5
          I will be participating in an open label clinical trial for Ocrelizumab in January. I have RRMS and was wondering if anyone else out there is participating as well. Dave mentioned the rituxan, which is very similar. I was also wondering how soon you may have noticed it working. I am currently un-medicated as I await this study and I am becoming very irritated as many symptoms resurface.

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