B-Cell Depletion for Treatment of Primary Progressive Multiple Sclerosis

In the OLYMPUS trial, as suspected, suppressing B lymphocyte activity with rituximab did not usefully affect primary progressive multiple sclerosis, at least over 96 weeks.

These researchers hypothesized that primary progressive multiple sclerosis (PPMS) is at least partially mediated by B cells. To test this hypothesis, they conducted the OLYMPUS trial, a manufacturer-sponsored, multicenter, randomized, double-blind trial of rituximab — a monoclonal antibody against CD20 B cells — in 439 patients with PPMS, moderate baseline disability (Expanded Disability Status Scale [EDSS] score, 2.0–6.5), and immunoglobulin G oligoclonal bands demonstrated in the cerebrospinal fluid within the previous 24 months. Participants received placebo or rituximab (1g) by intravenous infusion twice within a 2-week period on four occasions during the 96-week trial (i.e., 8 injections total), which 365 patients completed. The primar…

Reviewing Author

Alastair Compston, PhD, FRCP