Ocrelizumab: A Review in Multiple Sclerosis

Ocrelizumab (Ocrevus®) is an intravenously administered, humanized anti-CD20 monoclonal antibody approved for the treatment of adults with relapsing forms of multiple sclerosis (RMS) or primary progressive multiple sclerosis (PPMS). The efficacy of ocrelizumab in reducing relapse rates and disease activity in patients with RMS was demonstrated in pivotal trials (versus interferon β-1a) and supporting single-arm studies in specific subpopulations. In patients with PPMS, ocrelizumab reduced measures of clinical and MRI progression relative to placebo. Clinical benefits were maintained over ≥ 7.5 study years of treatment. Ocrelizumab was generally well tolerated and no new safety signals have emerged with long-term use. Extensive (albeit short-term) real-world data pertaining to ocrelizumab is consistent with that from clinical trials. Ocrelizumab provides the convenience of short, half-yearly infusions. Ocrelizumab continues to represent a generally well-tolerated, high-efficacy disease-modifying therapy (DMT) for RMS and is a valuable treatment for delaying disease progression in patients with PPMS (for whom there are currently no other approved DMTs).Multiple sclerosis (MS) is a chronic, immune-mediated, neurodegenerative disease of the CNS. In most patients, it starts as relapsing-remitting MS (RRMS), which involves exacerbations of neurological symptoms (i.e. relapses) followed by periods of remission. In the less common primary progressive MS (PPMS), disability accrues steadily from disease onset. It is now understood that B cells play key roles in MS pathophysiology. Ocrelizumab (Ocrevus®), a monoclonal antibody that selectively depletes CD20+ B cells, is approved for treating adults with RMS and PPMS in various countries worldwide. Ocrelizumab reduces relapse rates and indicators of disease activity in patients with RMS, and delays the worsening of disability in patients with RMS and PPMS. Of convenience to patients, ocrelizumab is intravenously administered every six months and can be infused rapidly (over ≈ 2 hours) without its safety being substantially altered. Ocrelizumab is a generally well-tolerated and highly effective treatment option for RMS and constitutes the first approved pharmacotherapy for PPMS.