12-month follow-up of patients with primary progressive multiple sclerosis using ocrelizumab in a quarternary hospital outpatient clinic and private practice

Introduction: Multiple sclerosis has a prevalence in Brazil of approximately 40,000. It is estimated that approximately 10% of these patients have the primarily progressive form (PPMS), which is characterized by a gradual and steady disease progression without the occurrence of demyelinating inflammatory outbreaks. In 2017, the ORATORIO study demonstrated that therapy with ocrelizumab was associated with a reduction in PPMS clinical progression (RR 0.75, CI95% 0.58-0.98). Since 2018, ANVISA has approved the medication for usage in PPMS. Objectives: To analyze the clinical evolution through the EDSS (Expanded Disability Status Scale) of patients diagnosed with PPMS using ocrelizumab. Methods: This is a retrospective observational real-life study, analyzing all patients diagnosed with PPMS who received at least 03 cycles of ocrelizumab 600mg (12 months of treatment) at a quaternary hospital neuroimmunology clinic and private doctor’s office from the coordinating physician of this clinic. The EDSS prior to medication use was compared with the EDSS 12 months after treatment began. Results: Data from 14 patients were analyzed, 9 of which were female, with a mean age of 44 years (minimum 26 and maximum 71). The mean time between diagnosis and medication initiation was 5.21 years (95% CI 0.93-9.5). The mean EDSS at the beginning of therapy was 5.39 (95%CI 4.57–6.22). After 3 courses of medication, patients mean EDSS was 5.11 (95%CI 4.13–6.08), with a functional scale reduction in 7 patients and stabilization in 4 patients. No serious side effects have been reported. Conclusion: These results allow us to conclude that 11 of the 14 patients improved clinically or remained stable, according to the EDSS. In addition, the drug proved to be safe for all patients in the study.