Potential Adverse Reactions of Ocrevus and Strategies for Their Management
Ocrevus (ocrelizumab) is a biologic drug used to treat multiple sclerosis (MS) and clinically isolated syndrome (CIS) in adults. It belongs to the monoclonal antibody drug class and is administered as an IV infusion.
The long-term side effects of Ocrevus primarily include infusion-related reactions, increased susceptibility to infections, and a slight increase in neoplasm incidence.
Infusion reactions are common, especially with the first infusion. Symptoms can include redness, tenderness at the infusion site, headache, nausea, pain, swelling, and itching. Most infusion-related adverse events tend to be mild to moderate and often decrease over time.
Infections are reported frequently, including upper respiratory tract infections and urinary tract infections. Infections can be more serious due to the immunosuppressive mechanism of Ocrevus, which targets B cells, a type of immune cell involved in infection defense.
Neoplasms (both benign and malignant tumors) occurred at a higher rate with Ocrevus compared to placebo or interferon beta-1a in trials—approximately 2.3% vs. 0.8%, respectively. This increase necessitates continued monitoring but does not conclusively establish causality.
Upper and lower respiratory infections are two of the most common side effects reported by people receiving Ocrevus in clinical trials. Upper respiratory infections (such as the common cold) were more common than lower respiratory infections (such as pneumonia).
In people with a relapsing form of MS or CIS, depression and pain in the arms, back, or legs are also common side effects. If you develop symptoms of a skin infection or pain in your arms, back, or legs while receiving Ocrevus, call your doctor.
Some side effects may last long term and continue to cause symptoms after stopping Ocrevus, such as skin infections and cancer. Treatment with Ocrevus may increase the risk of cancer, including breast cancer. People who took the drug in clinical trials had a higher rate of cancer development than people who took a placebo or a similar drug.
It's important to talk with your doctor about your health history before receiving Ocrevus, as the drug may not be suitable for people with certain medical conditions or factors that affect their health. If you have symptoms of an allergic reaction, call your doctor right away. For severe symptoms, call 911 or your local emergency number.
Ocrevus is unlikely to cause weight gain, but some people receiving Ocrevus for PPMS reported swelling in their arms and legs, which can cause weight gain. There are no known interactions between Ocrevus and alcohol.
If you're pregnant or planning to become pregnant, talk with your doctor before you start Ocrevus treatment, as it isn't known whether Ocrevus is safe to receive during pregnancy. It isn't known whether Ocrevus passes into breast milk or whether the drug may affect a child who is breastfed. If you're breastfeeding, talk with your doctor about the best way to feed your child while you're receiving treatment for MS or CIS.
Ocrevus is approved to treat multiple sclerosis (MS) in adults, including active secondary progressive MS (SPMS), relapsing-remitting MS (RRMS), primary progressive MS (PPMS), and clinically isolated syndrome (CIS). Symptoms of cancer vary depending on the type of cancer. For example, symptoms of breast cancer may include a lump in the breast, discharge from the nipple, and pain in the breast or nipple.
Allergic reactions to Ocrevus can be mild or severe. Mild symptoms may include a mild rash, while severe symptoms may include swelling or trouble breathing. Symptoms of skin infections include discoloration, swelling, pain, skin that's warmer than usual, and rash.
Infusion side effects can occur during or up to 24 hours after an Ocrevus infusion and may include headache, fatigue, trouble breathing, increased heart rate, skin itchiness or discoloration, and mouth pain or swelling.
Joint pain may occur with Ocrevus, but it wasn't reported as a side effect in clinical trials. Ocrevus is unlikely to cause tooth or dental problems, but MS may lead to dental problems. Skin infections can be a side effect of Ocrevus, particularly in people with primary progressive multiple sclerosis (PPMS).
In summary, the main long-term side effects of Ocrevus include infusion-related reactions, increased susceptibility to infections, and a slight increase in neoplasm incidence. These risks underscore the importance of careful patient selection, monitoring, and managing infusion timing to minimize symptom fluctuations.
- The drug Ocrevus (ocrelizumab), a treatment for multiple sclerosis (MS) and clinically isolated syndrome (CIS), has side effects that may include multiple infusion-related reactions, increased susceptibility to a variety of infections, and an increased risk of neoplasm.
- People receiving Ocrevus may experience common upper and lower respiratory infections, with upper respiratory infections being more prevalent than lower respiratory infections.
- Depression and pain in the arms, back, or legs are also common side effects in those with a relapsing form of MS or CIS, and it's crucial to consult a doctor if such symptoms arise.
- Some side effects may persist even after ceasing Ocrevus treatment, such as skin infections and cancer, with a higher rate of cancer development observed in clinical trial participants receiving the drug.
- It is essential to have a thorough discussion with a healthcare professional about one's medical history before starting Ocrevus, as the drug may pose risks for certain medical conditions, pregnancies, or breastfeeding individuals.
