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NICE approve use of ocrelizumab (Ocrevus▼) in treatment of primary progressive multiple sclerosis

Ocrevus▼, for Multiple sclerosis from Roche Products Limited

The National Institute for Health and Care Excellence (NICE) have approved Roche's multiple sclerosis treatment ocrelizumab, brand name Ocrevus▼, for the treatment of primary progressive multiple sclerosis.

This means that Ocrevus can be prescribed and funded by the NHS in England and Wales.

NICE state that ocrelizumab is recommended as an option for treating early primary progressive multiple sclerosis with imaging features characteristic of inflammatory activity in adults. It is recommended only if the company provides it according to the commercial arrangement.

Commercial arrangements are agreements between the manufacturer and the NHS, usually specifying a set of conditions under which reimbursement for the medicine will be made.

NICE had previously approved Ocrevus in the treatment of adult patients with relapsing forms of multiple sclerosis (RMS) with active disease defined by clinical or imaging features.

You can follow developments on Ocrevus by using our Medicines Tracker service which provides users with updates about the medicines they are interested in.

Why the NICE committee made these recommendations
There are currently no disease-modifying treatments available for primary progressive multiple sclerosis. Results of 1 clinical trial show that ocrelizumab can slow the worsening of disability, although the size and duration of this effect are uncertain.

Given the unmet clinical need, the most plausible cost-effectiveness estimates for ocrelizumab at the agreed price compared with best supportive care alone are in the range that NICE considers an acceptable use of NHS resources. Because of this, ocrelizumab is recommended for treating early primary progressive multiple sclerosis with imaging features characteristic of inflammatory activity in adults.

About Ocrevus (source EMA)
Ocrevus is a medicine for treating multiple sclerosis – an inflammatory disease of the nervous system that causes symptoms such as weakness, difficulty walking and problems with vision.

Ocrevus is used in two types of patients:
  • adults with relapsing forms of multiple sclerosis (RMS), where the patient has flare-ups (relapses) followed by periods with milder or no symptoms;
  • adults with primary progressive multiple sclerosis (PPMS), where symptoms get steadily worse over time
The active substance in Ocrevus, ocrelizumab, is a monoclonal antibody designed to recognise and attach to a target called CD20 on the surface of certain types of white blood cells (so called B cells).

These white blood cells play a role in multiple sclerosis by attacking the sheaths around the nerves in the brain and spinal cord, causing inflammation and damage. By targeting the B cells, Ocrevus helps to reduce their activity and thereby relieves symptoms or slows down the worsening of the disease.

Studies showed that Ocrevus was more effective than interferon beta-1a at reducing the number of relapses in patients with relapsing forms of multiple sclerosis. Ocrevus treatment also provided some benefit in patients with primary progressive multiple sclerosis, a condition for which treatments are urgently needed.

Ocrevus was first made available in the EU in 2018. It is manufactured by Roche.

Sources
European Medicines Agency website page for Ocrevus
Accessed 13/06/19
Links available in full article

© NICE [2019]

Ocrelizumab for treating primary progressive multiple sclerosis. Technology appraisal guidance [TA585] Published date: 12 June 2019
Available from: See Link below. All rights reserved. Subject to Notice of rights
NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/publication.

The information provided by NICE was accurate at the time this article was issued.


NICE information on Ocrevus in treating primary progressive multiple sclerosis

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