Evaluating the aT2-LV Biomarker for MS: Robert Zivadinov, MD, PhD


The professor of neurology and director of the Buffalo Neuroimaging Analysis Center discussed the findings of the post-hoc analysis of the ORATORIO study.

"The main message of this finding is that aT2-LV is really a good marker over such a short period of time—2 years in the pivotal study ORATORIO—to distinguish people who progress and people who do not progress... The second important thing was that it provides us with more understanding that drugs that act against the B cell component of the disease like ocrelizumab may really change the neurodegenerative outcomes.”

Data from a recent study suggest that ocrelizumab (Ocrevus; Genentech) reduces atrophied T2-lesion volume (aT2-LV) in patients with primary progressive multiple sclerosis (PPMS). These findings were presented 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, at the 2021 American Academy of Neurology (AAN) Annual Meeting, April 17-22.

Zivadinov and colleagues conducted a post-hoc analysis of the ORATORIO trial (NCT01194570) and evaluated data from 732 patients with PPMS 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 findings of the ORATORIO study and the post-hoc analysis. He also spoke about the value of aT2-LV as an MS 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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