Multiple sclerosis (MS) is a chronic autoimmune disorder of the central nervous system. It damages the myelin sheath — the protective sleeve that wraps around neurons — causing symptoms such as fatigue, numbness, and vision problems. If left untreated, patients with MS face the risk of accelerated disease progression, rapid disability, and brain atrophy (loss of neurons and connections between neurons).
An already-approved MS drug can significantly slow progression in people with primary progressive multiple sclerosis (PPMS), according to a new study.
Patients treated with an IV infusion of ocrelizumab (Ocrevus) were less likely to have progression of their disability, researchers report in The Lancet.
Specifically, they had better hand function and arm dexterity, and they were less likely to need a wheelchair, researchers found.
“These findings are important because they show that treatment can make a meaningful difference to people with more advanced forms of MS and can help preserve hand and arm function, which is important for maintaining independence, daily activities, and quality of life,” lead researcher Gavin Giovannoni said in a news release. He’s a professor of neurology at Queen Mary University of London.
PPMS affects between 10 percent and 15 percent of people with multiple sclerosis, researchers said in background notes. Unlike relapsing forms of MS, disability worsens progressively over time, limiting treatment options.
There has been ongoing debate about whether people with more advanced MS might benefit at all from treatments like ocrelizumab, researchers said.
Ocrelizumab is currently prescribed to treat relapsing forms of multiple sclerosis, according to Drugs.com. It works by targeting and removing immune cells that promote MS-related inflammation.
For the new study, researchers recruited more than 1,000 PPMS patients across 22 countries, randomly assigning half to receive IV ocrelizumab every six months for nearly three years. The other half received a placebo IV, administered in the same way as the active drug.
Overall, patients treated with ocrelizumab had a 30 percent lower risk of disability progression, results showed.
Ocrelizumab also reduced the worsening of hand and upper-limb function by 41 percent at 12 weeks, and reduced the risk of requiring a wheelchair by 52 percent, researchers said.
Patients benefited even more if they had signs of inflammatory disease activity on baseline MRI scans, researchers said. There was a 55 percent lower risk of progression in those patients.
“MS can be debilitating, exhausting, and unpredictable, and hand and arm function is essential for helping people to remain independent,” said Catherine Godbold, senior research communications manager at the MS Society in London.
“Many previous trials have focused solely on walking ability as a measure of whether a drug is effective. But trials like this are vital in helping us find treatments for everyone,” added Godbold, who reviewed the findings.
“Ocrelizumab is already used as a treatment for active relapsing MS and early primary progressive MS. These results could mean it is made available for more people with primary progressive MS, who don’t currently have access to any treatment options,” she said in a news release. “The key now is how we work together to see these findings translated into clinical practice.”
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Progressive multiple sclerosis is a steady, gradual decline in neurological function over time, rather than alternating periods of attacks and recovery. It causes the accumulation of physical and cognitive disabilities.
It is split into two main types:
Although MS has long been viewed as a disease that primarily affects white women, studies now show that Black Americans can experience more aggressive disease, faster disability progression, and greater symptom burden. Black patients may develop mobility challenges earlier and report poorer quality of life related to MS.
The possibility of slowing disability progression could be especially meaningful for Black patients who are at risk of worse outcomes.
Black patients are more likely to encounter barriers that can delay diagnosis and treatment, including:
Early recognition and treatment for MS remain critical for preserving function and independence.
Historically, Black patients have been underrepresented in MS clinical trials. When study populations don’t reflect the people most affected by a disease, it’s difficult to know whether treatment works equally across diverse communities.
Increasing Black participation in MS medical research can help ensure future therapies are effective, safe, and accessible for everyone living with the condition.
RELATED: Understanding Multiple Sclerosis Clinical Trials
For years, people living with progressive multiple sclerosis have had few options to slow worsening disability. While additional review and implementation are needed for ocrelizumab, these findings represent another step forward — and a reminder that equitable access to diagnosis, specialty care, and research participation must be part of the conversation for Black communities.
More information
Johns Hopkins Medicine has more about primary progressive multiple sclerosis.
SOURCE: Queen Mary University of London, news release, May 28, 2026
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