MSNEWS
After approximately three years, 33 % of participants receiving ocrelizumab experienced worsening disability compared with 40 % receiving placebo.
600 mg of intravenous ocrelizumab or a placebo every six months for up to 36 months or until the disability increased significantly.
Participants received MRI scans at the beginning of the study. They also completed tests of arm and hand function, including the 9-Hole Peg Test. The study examined how well ocrelizumab worked for delaying disability progression compared to placebo.
THE OUTCOME
After approximately three years, 33 % of participants receiving ocrelizumab experienced showed worsening disability compared with 40 % receiving placebo. This was a 30 % reduction in the relative risk of disability progression when using ocrelizumab. The benefit was even more pronounced among participants who had active inflammation on MRI at screening( 55 % reduction) and less pronounced in those without active inflammation on MRI at screening( only 11 % reduction). Ocrelizumab was generally well tolerated, although there was a slightly higher rate of infections with ocrelizumab.
Although the findings suggest that ocrelizumab can help delay disease progression in more disabled patients, nearly one-third of treated participants still experienced progression and the greatest benefit appeared to be in those with active inflammation at baseline. Additional analysis of this clinical trial dataset and longer term follow-up will be needed to understand the impact of ocrelizumab in more disabled patients with PPMS.
Giovannoni, G., Airas, L., Bove, R., et al.( 2026). Oratorio-hand: Results of the primary analysis of ocrelizumab vs placebo in primary progressive multiple sclerosis, including older patients and those with more advanced disease( S40.001). Neurology, 106( 11 _ Supplement _ 1). https:// doi. org / 10.1212 / wnl. 0000000000215551
Study Links Frailty to Greater Disability in Progressive MS
FRAILTY CAN MATERIALIZE as reduced strength, slowness, and low physical endurance, and because it measures reduced reserve and vulnerability to stressors, it may help predict a decline in people with MS. In a British study, MS was the top long-term condition associated with frailty, indicating that more advanced disability often coincides with frailty.
THE STUDY
This prospective, cross-sectional, multicenter study included 106 people with progressive MS. Researchers compared 53 people with late severe progressive MS who required skilled nursing care with 53 age-, sex-, and disease-duration-matched people with progressive MS who did not require skilled nursing. Participants experienced neurological and MRI assessments and provided blood samples. Frailty was measured using the Edmonton Frail Scale( EFS); disability was assessed using the Expanded Disability Status Scale( EDSS). Researchers also examined inflammatory and metabolic vulnerability using blood samples.
THE OUTCOME
Frailty was much more common among participants with late severe progressive MS; 73.1 % were classified as frail compared with 23.1 % of the control group. The late severe group also had higher average frailty scores( 8.87 vs. 5.52) and greater disability, with a median EDSS score of 8.0 compared with 6.0 for the control group. Across both groups, greater frailty was associated with greater disability. In the control group, frailty was also associated with inflammatory and metabolic vulnerability.
This study had a few limitations. The number of people included in the study was small. All participants with severe progressive MS came from one skilled nursing facility.
Frailty is associated with greater levels of disability in people with MS. But the study suggests something more. If we could learn more about frailty, we may be able to tailor treatments for it and improve the health of people with MS.
Wicks, T. R., Wolska, A., Ghazal, D., et al.( 2025). Frailty exacerbates disability in progressive multiple sclerosis. Annals of Clinical and Translational Neurology, 13( 4), 654 – 664. https:// doi. org / 10.1002 / acn3.70243
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