Treatment of Primary Progressive Multiple Sclerosis in Ambulatory Patients

Ambulatory primary progressive multiple sclerosis (PPMS) is a specific clinical scenario in which a disease-modifying therapy has demonstrated evidence for altering disease progression. Identifying eligible patients and offering appropriate treatment in a timely manner is the core focus of this protocol.

Clinical Scenario

This protocol applies to patients with confirmed primary progressive multiple sclerosis who retain ambulatory function. Evidence supports that a targeted disease-modifying therapy can be offered to this population when the likely benefits outweigh the risks of treatment.

Treatment approach: A specific disease-modifying agent — the only one with demonstrated efficacy for altering progression in ambulatory PPMS — forms the basis of this first-line protocol. Patient eligibility and benefit-risk assessment guide its use.

Full eligibility criteria, treatment initiation guidance, and the complete regimen are available in the structured protocol →

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1212/WNL.0000000000005347

Ocrelizumab is the only DMT shown to alter disease progression in individuals with primary progressive MS (PPMS) who are ambulatory.

Clinicians should offer ocrelizumab to people with PPMS who are likely to benefit from this therapy unless there are risks of treatment that outweigh the benefits (Level B).

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