Ocrevus (ocrelizumab) is a disease-modifying therapy used to treat relapsing forms of multiple sclerosis (MS). Like Kesimpta and Briumvi, it is an anti-CD20 therapy that targets certain B cells involved in the abnormal immune activity that occurs with MS.
Ocrevus is a humanized monoclonal antibody. This means it is a lab-made antibody designed so that most of its structure is similar to antibodies found in the human body. “Humanized” describes the medication’s structure and does not mean it is safer or more effective than other anti-CD20 therapies.
Your healthcare team will consider the type and stage of MS, previous treatment, infection risk, antibody levels, liver function, vaccination history, other health conditions, current medications, and pregnancy plans before deciding whether Ocrevus is an appropriate treatment for you.
Ocrevus is also approved for certain children with RRMS and adults with primary progressive MS (PPMS). With PPMS, symptoms and physical problems gradually worsen from the beginning, usually without periods of relapses and remissions.
Ocrevus is used for long-term control of MS. For relapsing forms of MS, it can help reduce future relapses and new MS activity, but it does not stop a relapse that has already started or directly relieve current symptoms.
Ocrevus targets certain B cells, which are part of the immune system. B cells normally help the body fight infections and build protection after vaccination. In MS, some B cells also take part in the immune attack that causes inflammation and damage in the brain and spinal cord.
Many of the B cells involved in this attack carry a protein called CD20. Anti-CD20 therapies attach to this protein and help the immune system remove these B cells. Decreasing the number of these cells reduces immune activity that can cause new RRMS damage.
Ocrevus is given by a trained healthcare professional as an infusion.
Treatment begins with two infusions:
Before each infusion, patients receive a corticosteroid, such as methylprednisolone, and an antihistamine, such as diphenhydramine. These medications help reduce the chance and severity of a possible infusion reaction. Acetaminophen may also be considered.
Patients are monitored during the infusion and for at least one hour after it is completed.
In the Phase 3 OPERA I and OPERA II trials, Ocrevus reduced annualized relapse rates by about 46% to 47% compared with Rebif and reduced new or enlarging MS lesions seen on MRI.
Importantly, Ocrevus has also been studied specifically in Black and Hispanic people with relapsing MS. The Phase 4 CHIMES study intentionally enrolled 182 participants who had historically been underrepresented in MS clinical trials, including 113 Black participants. After 48 weeks of Ocrevus treatment, 50.5% of participants overall had no evidence of disease activity, while more than 94% had no relapse, no confirmed disability progression, and no new contrast-enhancing MRI lesions. The study’s two-year results continued to show that Ocrevus controlled MS disease activity in Black and Hispanic patients, with results consistent with those seen in the larger Ocrevus trials.
Black people with MS may experience a more severe disease course and faster disability progression than White people. They have also historically been underrepresented in MS clinical trials, making it harder to know whether treatment results apply equally across populations.
Ocrevus is one of the MS treatments with meaningful research specifically in Black patients. In the CHIMES study, which was designed to address this gap, 113 Black people with relapsing MS received Ocrevus for two years. The results showed that Ocrevus controlled disease activity in this population, with findings consistent with those seen in the larger clinical trials.
Earlier research from the OPERA trials also looked specifically at 72 participants of African descent. Ocrevus was associated with about a 50% reduction in annualized relapse rate compared with Rebif, along with substantially fewer new MRI lesions. Participants of African descent receiving Ocrevus were also 2.61 times more likely to achieve no evidence of disease activity than those receiving Rebif.
These findings do not mean that Ocrevus works differently — or better — for Black patients. Rather, they provide encouraging evidence that Ocrevus can effectively control MS disease activity in Black patients, while highlighting the importance of continuing to include Black people in MS research.
Infusion reactions are among the most common side effects and occur most often with the first infusion. Symptoms may include itching, rash, flushing, throat irritation, fever, headache, nausea, dizziness, or trouble breathing.
Seek immediate medical treatment for:
Serious risks associated with anti-CD20 therapy may include serious infections, severe infusion reactions, low antibody levels, liver injury, and progressive multifocal leukoencephalopathy (PML), a rare but serious brain infection.
**Ocrevus can also cause colitis, which is swelling and irritation in the large intestine. Warning signs may include ongoing diarrhea, stomach pain, or blood in the stool.
**Ocrevus may increase the risk of cancer, including breast cancer. Patients should follow recommended breast cancer screening guidelines and remain up to date with all other recommended cancer screenings.
Patients should contact their healthcare team about new or worsening symptoms, signs of infection, ongoing diarrhea, stomach pain, blood in the stool, or reactions that are severe or do not improve.
During treatment, the healthcare team continues to monitor for infections, changes in antibody levels, liver problems, and reactions related to an infusion. Treatment may be delayed when an active infection is present.
Patients with relapsing multiple sclerosis can find access to Ocrevus through several program options. Some of those programs may help lower out-of-pocket costs for eligible patients with private insurance, help patients and healthcare teams understand insurance coverage and available financial assistance, or provide Ocrevus at no cost to eligible patients who are uninsured or meet certain financial requirements. Learn more about savings and support for Ocrevus.
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking any drug or commencing or discontinuing any course of treatment.
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