Does Ocrevus (ocrelizumab) cause pleural effusion?

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Last updated: March 1, 2025View editorial policy

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From the Research

Ocrevus (ocrelizumab) is not known to directly cause pleural effusion as a common or established side effect. The most recent and highest quality study on pleural effusion, published in 2019 1, does not mention Ocrevus as a cause of pleural effusion. Pleural effusion, which is an abnormal accumulation of fluid between the layers of tissue lining the lungs and chest cavity, is not listed among the recognized adverse reactions in Ocrevus's safety profile. Ocrevus is a monoclonal antibody that targets CD20-positive B cells and is primarily used to treat multiple sclerosis. The most common side effects of Ocrevus include infusion reactions, upper respiratory tract infections, and skin infections. While respiratory complications can occur with Ocrevus, these typically manifest as infections rather than pleural effusions.

Some key points to consider when evaluating pleural effusion in patients taking Ocrevus include:

  • The most common causes of pleural effusion are congestive heart failure, cancer, pneumonia, and pulmonary embolism, as noted in the 2019 study 1
  • Pleural fluid puncture (pleural tap) enables the differentiation of a transudate from an exudate, which remains the foundation of the further diagnostic work-up, as stated in the 2019 study 1
  • If a patient taking Ocrevus develops symptoms suggestive of pleural effusion (such as shortness of breath, chest pain, or dry cough), they should seek medical attention promptly as this would be considered an unusual reaction that requires investigation for other potential causes.

The development of pleural effusion in a patient on Ocrevus would likely warrant consideration of alternative explanations, including infections, heart failure, malignancy, or other inflammatory conditions, as discussed in the 2019 study 1. It is essential to prioritize the patient's morbidity, mortality, and quality of life when evaluating and managing pleural effusion, and to consider the latest evidence and guidelines in making treatment decisions.

References

Research

Pleural Effusion in Adults-Etiology, Diagnosis, and Treatment.

Deutsches Arzteblatt international, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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