Assessing Atrophied Lesion Volume in Progressive MS: Robert Zivadinov, MD, PhD


The professor of neurology and director of the Buffalo Neuroimaging Analysis Center discussed the background of the ORATORIO study and the aT2-LV biomarker.

“In 2 studies, in particular, we look at long-term effect up to 10 years, and found that the amount of lesions that were actually disappearing is pretty constant, especially increasing toward the progressive stages. It's also very predictive, early, of the long-term outcomes.”

A recent study presented at the 2021 American Academy of Neurology (AAN) Annual Meeting, April 17-22, by Robert Zivadinov, MD, PhD, professor of neurology and director, Translational Imaging Center, Clinical Translational Research Center, Buffalo Neuroimaging Analysis Center, and director, Buffalo Neuroimaging Analysis Center, suggests that ocrelizumab (Ocrevus; Genentech) reduces atrophied T2-lesion volume (aT2-LV) in patients with primary progressive multiple sclerosis (PPMS).

Zivadinov and colleagues evaluated data from 732 patients with PPMS as part of a post-hoc analysis of the ORATORIO trial (NCT01194570), who were randomly assigned to ocrelizumab (n = 488) or placebo (n = 244). The researchers confirmed that accumulation of aT2-LV in patients receiving placebo (366.1mm3 in 120 weeks) was consistent with previous reports in PPMS and thus further validated the biomarker’s accuracy. They found that patients treated with ocrelizumab had significantly slower accumulation of aT2-LV (319.4mm3; P = .013). Including scanner model, software, protocol changes, and additional covariates further confirmed these results (P = .029).

NeurologyLive spoke with Zivadinov to learn more about the development of the aT2-LV biomarker. 

Zivadinov R, Pei J, Clayton D, et al. Evolution of lesions that shrink or disappear into cerebrospinal fluid (atrophied t2 lesion volume) in primary-progressive multiple sclerosis: Results from the phase III ORATORIO study. Presented at 2021 American Academy of Neurology Annual Meeting; April 17-22, 2021. Abstract P15 151
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