Imaging Demonstrates Ocrelizumab’s Impact in Progressive MS: Robert Zivadinov, MD, PhD


The professor of neurology and director of the Buffalo Neuroimaging Analysis Center discussed his work on the ORATORIO study.

“The primary objective of the study was to see if this biomarker is reflective of progression or conversion to more disability and progressive stages of PMS. Does ocrelizumab’s mechanism of action slow down accumulation of the atrophied lesion volume?”

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

As part of the ORATORIO trial (NCT01194570), Zivadinov and colleagues evaluated data from 732 patients with PPMS who were randomized 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 ORATORIO study’s objectives and findings. He also discussed efforts to determine ocrelizumab efficacy between patient populations.

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. Abstract P15 151
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