Ocrelizumab (Ocrevus)

Ocrelizumab is a medicine designed to treat multiple sclerosis.  It is indicated for relapsing remitting MS (RRMS) and primary progressive MS (PPMS).  It is made by Genentech.

Ocrelizumab is given by the IV route, 600 mg every 6 months.  The retail cost of the medication is $65000 per year.

Ocrelizumab is an anti CD20 antibody.  It reduces the number of B lymphocytes in the immune system.  It is similar to an older medicine named rituximab.

Clinical trial results

In 480 patients with PPMS treated with ocrelizumab, progression of PPMS was slowed by 24%.   This was assessed over 96 weeks.

For 800 patients with RRMS treated with ocrelizumab, there was a significant reduction in relapses in  over 96 weeks.  Patients treated with ocrelizumab had a 46% reduction in relapses compared to those treated with beta interferon 1a.   About half of the patients had no relapses or new MRI lesions while using ocrelizumab.

Adverse events

Side effects of ocrelizumab are generally reported as mild.  They include infusion site reactions, headache, back pain, fatigue, influenza, upper respiratory tract infection, or depression.

Ocrelizumab should not be used in patients with hepatitis B or other infections.  Ocrelizumab may be associated with a higher rate of new malignancies (cancers) compared to interferon.

 

References:

Hauser SL, et al.  New Eng J Med.  2017  Jan 19   276(3): 221-234

Montalban X, et al.  New Eng J Med.  2017  Jan 19  376(3): 209-220