Eligibility and implementation of disease-modifying therapy for primary progressive multiple sclerosis in a UK cohort.
BACKGROUND
As disease-modifying therapies become approved for primary progressive multiple sclerosis (PPMS), services must be aligned in readiness.


METHODS
In this paper we use population and clinic-based data to estimate eligibility rates for ocrelizumab, and the extent of additional service requirements necessary to ensure its widespread introduction in PPMS.


RESULTS
Overall population estimates for the incidence and prevalence of people with PPMS who are eligible for ocrelizumab are 1.6 and 4.2 per 100,000 respectively. The majority (87%) of incident cases of PPMS satisfied clinical eligibility criteria for ocrelizumab but lacked radiological evidence of disease activity due to a historical tendency not to routinely monitor using MRI in this group. The majority of prevalent patients did not satisfy clinical eligibility criteria for ocrelizumab, mainly because of advanced disease duration or disability.


CONCLUSIONS
These findings illustrate the fact that there has been a tendency for people with PPMS not to receive routine clinical and radiological monitoring. Additional planning or resources will be required to facilitate contemporary disease re-evaluation and surveillance at a population level.
['Tallantyre|Emma C|EC|', 'Castle|Daniel|D|', 'Karamura|Paul|P|', 'Brice|Thomas A W|TAW|', 'Joseph|Fady|F|', 'Harding|Katharine E|KE|', 'Robertson|Neil P|NP|']
D000328:Adult D000368:Aged D061067:Antibodies, Monoclonal, Humanized D015331:Cohort Studies D006233:Disabled Persons D004608:Eligibility Determination D000078336:Facilities and Services Utilization D005260:Female D006801:Humans D007155:Immunologic Factors D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D020528:Multiple Sclerosis, Chronic Progressive D012042:Registries D006113:United Kingdom
Primary progressive Multiple sclerosis Ocrelizumab Disease modifying treatment