Ocrevus (ocrelizumab) 300mg/10ml

Ocrevus (Ocrelizumab) is a prescription medication used to treat multiple sclerosis (MS), a chronic autoimmune disease that affects the central nervous system (CNS). Ocrevus is available as an intravenous (IV) infusion and comes in a strength of 300mg/10ml. This monoclonal antibody is specifically designed to target CD20-positive B-cells, which are thought to contribute to the damage to the CNS in patients with MS. Ocrevus is used in the treatment of both relapsing forms of multiple sclerosis (RMS) and primary progressive multiple sclerosis (PPMS), offering a broad-spectrum approach to managing different forms of this debilitating disease.

How Ocrevus Works

Ocrevus works by targeting and binding to CD20, a cell surface antigen expressed on B-cells, a type of white blood cell involved in the immune response. These B-cells are thought to play a key role in the autoimmune processes that lead to the inflammation and damage of the central nervous system in multiple sclerosis patients.

Mechanism of Action:

1. Binding to CD20: Ocrelizumab selectively binds to the CD20 antigen on the surface of B-cells, leading to their depletion.
2. B-cell Depletion: By targeting and depleting these B-cells, Ocrevus reduces the immune system’s attack on the myelin sheath that protects nerve fibers in the CNS.
3. Reduction in Disease Activity: The reduction in B-cell activity decreases inflammation, slows disease progression, and reduces the frequency of relapses in relapsing MS. In primary progressive MS, it helps slow the worsening of disability.

Ocrevus, through this specific mechanism, helps protect the nerves from further damage, improving the patient’s quality of life and reducing the likelihood of relapses.

Side Effects

Like all medications, Ocrevus can cause side effects, some of which may be mild and others more serious. It is important to monitor for side effects, especially during and after infusion.

Common Side Effects:

• Infusion-related Reactions: Fever, chills, rash, itchy skin, and shortness of breath may occur during or after the infusion.
• Upper Respiratory Tract Infections: Common cold-like symptoms, cough, and sore throat.
• Headache: Patients may experience moderate to severe headaches.
• Fatigue: Many patients report feeling unusually tired after treatment.
• Nausea: Some individuals may feel nauseous during or after treatment.

Serious Side Effects:

• Infections: Due to its immunosuppressive action, Ocrevus may increase the risk of infections, including serious ones such as pneumonia.
• Progressive Multifocal Leukoencephalopathy (PML): A rare but serious brain infection that can lead to death or severe disability. Monitoring is essential for early signs of this condition.
• Hepatitis B Reactivation: Patients with a history of Hepatitis B may experience reactivation of the virus.
• Cancer: There may be an increased risk of certain cancers, such as breast cancer, although this is still under investigation.

If any serious side effects occur, patients should contact their healthcare provider immediately.

Indications

Ocrevus is primarily indicated for the treatment of multiple sclerosis, particularly the relapsing and progressive forms. It is one of the few treatments approved for primary progressive multiple sclerosis.

Approved Indications:

1. Relapsing Multiple Sclerosis (RMS): Includes clinically isolated syndrome, relapsing-remitting MS (RRMS), and active secondary progressive MS (SPMS) to reduce relapses and slow disease progression.
2. Primary Progressive Multiple Sclerosis (PPMS): The only FDA-approved treatment specifically for primary progressive MS, which slows the worsening of disability in these patients.

Contraindications

While Ocrevus can be an effective treatment for many MS patients, certain conditions make it unsuitable for use.

Contraindications:

1. Active Infections: Ocrevus should not be given to patients with active infections due to its immunosuppressive nature.
2. Hepatitis B Virus: Patients with active hepatitis B infections should not take Ocrevus, as it may cause reactivation of the virus.
3. Severe Allergic Reactions to Ocrelizumab: Patients who have had life-threatening allergic reactions to ocrelizumab or any components of Ocrevus should not receive this medication.
4. Pregnancy: Ocrevus is contraindicated during pregnancy as it may harm the developing fetus. Women are advised to avoid becoming pregnant while on Ocrevus and for 6 months after treatment.

Price in Different Countries

The cost of Ocrevus varies based on country, healthcare system, and insurance coverage. Below is a table showing the estimated prices for Ocrevus in different countries.

Country	Price (Per Infusion)	Reference
United States	$60,000 – $70,000 (annual cost)	GoodRx
Canada	CAD $33,000 – $40,000 (annual cost)	DrugBank
United Kingdom	£19,000 – £21,000 (annual cost)	NHS UK
Australia	AUD $30,000 – $35,000 (annual cost)	PBS Australia
India	INR ₹40,00,000 – ₹45,00,000 (annual cost)	MedIndia

Top 5 Global Brands

Ocrevus is manufactured and distributed globally by several leading pharmaceutical companies. Below are the top five global brands in the multiple sclerosis treatment landscape.

1. Genentech (Roche)

• Genentech, a member of the Roche Group, is the manufacturer of Ocrevus and leads in the development of MS therapies.

2. Biogen

• Biogen is a global leader in neurology and produces several other treatments for multiple sclerosis, including Tecfidera and Tysabri.

3. Novartis

• Novartis produces Gilenya and other treatments for relapsing multiple sclerosis, offering innovative solutions for MS management.

4. Sanofi

• Sanofi is a top pharmaceutical company that develops treatments for MS, including Aubagio, offering alternatives in oral MS therapies.

5. Merck KGaA

• Known for producing Rebif, Merck KGaA is a well-established player in the MS treatment market, particularly in the relapsing forms of the disease.