Ocrelizumab was found to be associated with a greater mean improvement in low-contrast letter acuity (LCLA) in patients with relapse-remitting multiple sclerosis (RMS), especially in patients with visual impairment at baseline, according to data presented at MS Paris 2017, the 7th annual joint meeting of the European and Americas Committees for Treatment and Research in Multiple Sclerosis.
The OPERA I and II trials conducted binocular LCLA testing (1.25% and 2.5% contrast) and reported data for an intent-to-treat (ITT) patient group randomized to either ocrelizumab 600 mg (n=827) or interferon beta-1a 44µg (IFN ß-1a; n=829) every 12 weeks for 96 weeks, and a subgroup analysis of patients with visual impairment at baseline (ocrelizumab: n=375; IFN ß-1a: n=373).
“LCLA was able to capture the treatment benefiit of ocrelizumab versus IFN ß-1a on visual outcomes in patients with MS,” Laura Balcer, MD, lead author and professor of neurology and ophthalmology at New York University at Langone. “Evidenced by significantly greater mean improvement in LCLA score from baseline to Week 96, and a significantly higher proportion of patients with sustained improvement in LCLA scores, confirmed after 12 weeks.”
Improvement was seen particularly in the patients with visual impairment subgroup at 2.5% contrast, as 14.7% of patients in the ocrelizumab arm experienced 12-week confirmed visual improvement in at least 5 out of 7 visits, compared with 6.4% in the IFN ß-1a arm (Odds Ratio [OR] 2.72 [1.60-6.64], 95% CI; p≤0.001).
In the ITT population, the ocrelizumab arm experienced visual improvement at 2.5% contact in at least 5 of 7 visits at a rate of 10.4% compared with 7.1% in the IFN ß-1a group (OR 1.50 [1.04-3.17], 95% CI; p=0.030). The threshold of response was defined as a ≥7 letter improvement confirmed after ≥12 weeks of initial improvement.