Roche’s fenebrutinib is the first investigational medicine in over a decade that reduces disability progression in primary progressive multiple sclerosis (PPMS)

Core Insights - Roche announced that fenebrutinib, an investigational BTK inhibitor, met its primary endpoint of non-inferiority compared to OCREVUS in reducing disability progression in patients with primary progressive multiple sclerosis (PPMS), showing a 12% reduction in risk [1][5][6] Group 1: Study Results - The Phase III FENtrepid study involved 985 adult patients with PPMS, comparing daily oral fenebrutinib to intravenous OCREVUS for at least 120 weeks [7][12] - Fenebrutinib demonstrated a consistent treatment effect on the composite confirmed disability progression (cCDP12) across various patient subgroups, with curves separating as early as 24 weeks [1][2] - A post-hoc analysis indicated fenebrutinib was superior to OCREVUS on a composite endpoint, showing a 22% reduction in risk [3] Group 2: Treatment Effects - The strongest treatment effect was observed on the nine-hole peg test (9HPT), with a 26% reduction in the risk of worsening compared to OCREVUS [2] - Fenebrutinib showed a consistent clinical benefit in upper limb function, which is crucial for maintaining independence [3] Group 3: Safety Profile - Adverse events in the fenebrutinib group were comparable to OCREVUS, with infections occurring in 67.0% of patients on fenebrutinib versus 70.9% on OCREVUS [4] - Transient liver enzyme elevations were more frequent in the fenebrutinib group (13.3% vs 2.9% for OCREVUS), but all cases resolved after discontinuation [4] Group 4: Future Developments - Roche plans to submit regulatory applications for fenebrutinib in both PPMS and relapsing multiple sclerosis (RMS) following the readout of the second pivotal RMS study, FENhance 1, expected in mid-2026 [5][6]