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NICE approve use of Ocrevus▼ in the treatment of primary progressive multiple sclerosis

Ocrevus▼, for Multiple sclerosis from Roche Products Limited

The National Institute for Health and Care Excellence (NICE) are set to approve Roche's multiple sclerosis medicine ocrelizumab, brand name Ocrevus▼, for the treatment of primary progressive multiple sclerosis in adults. Ocrevus is already approved for use in treating relapsing remitting multiple sclerosis.

For more information and references, see full article.

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Just over 1 in 10 people start their MS with a gradual worsening of symptoms.

In primary progressive MS, symptoms gradually worsen and accumulate over several years, and there are no periods of remission, though people often have periods where their condition appears to stabilise.

In its final draft guidance published on 9 May 2019, NICE has reversed its previous draft decision not to recommend ocrelizumab for treating primary progressive multiple sclerosis (PPMS) in adults.

This follows an agreement between the company and NHS England on the terms of a new commercial arrangement which will make ocrelizumab, the first disease-modifying treatment for PPMS, available at a lower price. The details of the commercial arrangement are confidential.

Ocrelizumab has been shown to slow the advance of PPMS, although by how much and for how long are uncertain.

Given the unmet clinical need of people with this form of MS, the cost-effectiveness estimates for ocrelizumab at the new lower price compared with best supportive care alone are in the range that NICE considers an acceptable use of NHS resources.

Why the 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 protein, 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.

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

Sources
European Medicines Agency website page for Ocrevus
NHS website for multiple sclerosis
Contains public sector information licensed under the Open Government Licence v3.0.
Accessed 09/05/19
Links available in full article

© NICE [2019] Ocrelizumab for treating primary progressive multiple sclerosis [ID938] 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 primary progressive multiple sclerosis

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