Ocrevus

Ocrevus is the brand name for ocrelizumab, a humanized monoclonal antibody used as a disease-modifying therapy for multiple sclerosis (MS). It binds to CD20, a protein on the surface of certain B cells, and causes depletion of circulating B cells. This B-cell targeting is intended to reduce inflammatory activity in MS.

Ocrelizumab is approved for adults with relapsing forms of MS, including relapsing-remitting MS, and for adults with primary progressive MS (PPMS). It is marketed by Genentech, a subsidiary of Roche. The therapy is delivered by intravenous infusion on a set schedule: the initial dose is two 300 mg infusions given 2 weeks apart (total 600 mg), followed by 600 mg every 6 months.

Clinical trial evidence includes the OPERA I and II studies, which showed reduced relapse rates and disability progression in relapsing MS, and the ORATORIO study, which demonstrated slower disability progression in PPMS. Safety considerations include infusion-related reactions and an increased risk of infections, including upper respiratory tract infections and potential hypogammaglobulinemia with long-term use. Rare cases of malignancies and progressive multifocal leukoencephalopathy (PML) have been reported. Ocrelizumab may also affect immune responses to vaccines.

Before starting treatment, patients are typically screened for hepatitis B infection. Live vaccines are generally avoided during treatment, with non-live vaccines considered as appropriate. Pregnancy is not recommended during treatment and for a period after the last dose; patients should discuss family planning with their clinician. Ongoing monitoring includes assessment of infections, immunoglobulin levels, and B-cell counts.