ClinicSpeak: managing expectations

What are you expecting ocrelizumab to do for your PPMS? #ClinicSpeak #MSBlog #MSResearch

"In the past I have always warned that we should not expect too much from the first effective DMTs in progressive MS. They are unlikely to be miracle drugs. I therefore would like to prepare you for the ocrelizumab results when they are presented. In other words I want to set realistic expectations."

"I agree with all the comments from yesterday that the announcement of the positive ocrelizumab in PPMS trial results was great news; probably the best news we have had in a decade or more. However, I would like to remind you of a survey we did on this blog a few years ago (see slideshow below). About 40% of progressive MSers are expecting an effective DMT to improve their functioning or to result in a full recovery; this is unlikely to happen. At best ocrelizumab will stabilise your disease or more likely slow down the rate of disability progression. What this means is that progressive MSers on an effective treatment may not notice much. Getting worse more slowly may be difficult to notice on a background of progression. However, ocrelizumab is a start and will allow us to begin to target different processes in MS with the hope of developing add-on neurorestorative therapies. Innovation tends to be incremental; having an effective anti-inflammatory therapy for progressive MS provides the base of the pyramid; we now need to add the neuroprotective, remyelinative and neurorestorative tiers."



CoI: Multiple. Please note I do not at this stage know the results of the PPMS ocrelizumab trial.

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