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Ocrelizumab is a humanized monoclonal antibody used primarily in the treatment of multiple sclerosis (MS). Marketed under the brand name Ocrevus, it was developed by Genentech and approved by the U.S. Food and Drug Administration (FDA) in March 2017. Ocrelizumab targets CD20-positive B cells, which are believed to play a crucial role in the autoimmune process underlying MS. By binding to the CD20 antigen on B cells, it facilitates their depletion, thereby reducing inflammation and nerve damage.

Ocrelizumab is indicated for both relapsing forms of multiple sclerosis (RMS) and primary progressive multiple sclerosis (PPMS), making it notable as the first approved therapy for the latter. The medication is administered via intravenous infusion every six months, with the initial dose administered as two infusions two weeks apart.

Common side effects of ocrelizumab include infusion reactions, infections, and respiratory symptoms. Because it suppresses B cell activity, patients are at increased risk of infections, and monitoring for signs of infections is recommended during treatment. Furthermore, there is a potential risk of progressive multifocal leukoencephalopathy (PML), a rare brain infection.

Ocrelizumab has demonstrated efficacy in reducing relapse rates, slowing disability progression, and decreasing the number of brain lesions in MS patients, as evidenced by clinical trials. Its use has provided a targeted treatment option that addresses the autoimmune component of the disease with a distinct mechanism of action compared to other MS therapies.

Overall, ocrelizumab represents a significant advancement in multiple sclerosis treatment, especially for patients with primary progressive MS, although careful consideration of risks and benefits is essential in clinical decision-making.