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Researchers are evaluating RO7268489 as an add-on therapy to ocrelizumab in adults with progressive multiple sclerosis PMS. This phase II study aims to assess the safety, pharmacokinetics, pharmacodynamics, and effectiveness of RO7268489 in people with PMS, focusing on its impact on disability progression. Eligible participants have PMS and an Expanded Disability Status Scale EDSS score between 3.0 and 6.0. Participants are randomly assigned to receive one of three doses of RO7268489 or a placebo, all given alongside ocrelizumab following a predefined regimen. After the double-blind treatment phase, eligible participants may join an open-label extension to receive RO7268489 openly. The study uses a quadruple-blind design and compares these groups over approximately 110 weeks. During the study, participants will be regularly monitored for disability progression, brain volume changes, cognitive function, walking ability, hand function, and plasma levels of RO7268489 and its metabolites. Safety is tracked through adverse events and suicidal ideation assessments over up to five years. The study involves scheduled visits for treatment administration, assessments, and monitoring to thoroughly evaluate the impact of adding RO7268489 to ocrelizumab therapy.