A major international phase III trial has found that ocrelizumab can significantly slow disability progression in people with primary progressive multiple sclerosis, including older patients and those with more advanced disease. The ORATORIO-HAND study, led by Queen Mary University of London, involved more than 1,000 patients across 22 countries and was published on 28 May 2026 in The Lancet.
Trial results point to broader benefits than previously shown
The study reported a 30% lower risk of disability progression among patients treated with ocrelizumab compared with placebo. Researchers also found a 41% reduction in worsening hand and upper-limb function at 12 weeks and a 52% reduction in the risk of requiring a wheelchair among participants who were still unable to walk or move about freely at the start of the trial.
According to the research team, the effect was even stronger in patients who showed signs of inflammatory disease activity on baseline MRI scans, with a 55% reduction in the risk of disability progression in that group. The findings are notable because treatment options for primary progressive multiple sclerosis remain limited, and there has been ongoing debate about whether people with more advanced disease can still benefit from therapy.
A study designed to include patients often left out of earlier trials
Primary progressive multiple sclerosis affects an estimated 10% to 15% of people with MS and is marked by worsening disability over time. Previous major studies often excluded patients aged 55 and above or those with substantial mobility impairment, but ORATORIO-HAND included patients up to the age of 65 and a large number with advanced disease progression.
The investigators said the study was specifically designed to address whether ocrelizumab could still help in this broader population. The results suggest that the treatment may have a meaningful impact beyond the patient groups most commonly represented in earlier research.
What the findings could mean for MS care
While the trial does not remove the need for careful individual clinical decision-making, it may help inform future treatment discussions for people living with advanced progressive MS. The results add to the evidence base around disease-modifying therapy in a condition where options have been relatively few, especially for those with long-standing disability.
For clinicians and patients, the study provides new evidence that treatment effects may still be seen later in the disease course, particularly when there is active inflammation visible on MRI. As the findings are assessed further, they may influence how primary progressive MS is approached in specialist care settings.
The trial’s scale and broad patient inclusion make it one of the most relevant studies to date in this area, and its publication in The Lancet is likely to keep ocrelizumab at the center of discussion around progressive MS treatment in the months ahead.
Source: News-Medical report
