From the FDA Drug Label
OCREVUS ZUNOVO is indicated for the treatment of: ... Primary progressive MS, in adults OCREVUS ZUNOVO is indicated for the treatment of: ... Primary progressive MS, in adults
The approved treatment for Primary Progressive Multiple Sclerosis (MS) is ocrelizumab (IV), also known as OCREVUS ZUNOVO, administered subcutaneously in adults 1 1.
- The recommended dosage is 920 mg/23,000 units administered as a single 23 mL subcutaneous injection in the abdomen over approximately 10 minutes every 6 months.
- Key administration considerations include hepatitis B virus screening, assessments prior to first dose, and premedication with corticosteroid and antihistamine to reduce the risk of local and systemic injection reactions.
From the Research
Ocrelizumab (Ocrevus) is the primary FDA-approved treatment for primary progressive multiple sclerosis (PPMS), and it should be considered as the first-line treatment option. It is administered as an intravenous infusion, with the first dose split into two 300mg infusions given two weeks apart, followed by 600mg infusions every six months thereafter. The medication works by targeting CD20-positive B cells, which are believed to contribute to the myelin and axonal damage in MS, as supported by a real-world multicentric study published in 2024 2. This reduces inflammation and slows disability progression. Patients should be aware that premedication with methylprednisolone (or equivalent) and an antihistamine is typically given before each infusion to reduce infusion reactions. Common side effects include infusion reactions, upper respiratory tract infections, and increased risk of infections. Before starting treatment, patients should undergo screening for hepatitis B virus and tuberculosis. While ocrelizumab cannot reverse existing damage, clinical trials demonstrated it can slow disability progression by about 24% compared to placebo in PPMS patients, as reported in a study published in 2023 3. Regular monitoring by a neurologist is essential during treatment to assess effectiveness and manage any side effects.
Some key points to consider when treating PPMS patients with ocrelizumab include:
- The treatment is most effective when started early in the disease course, as suggested by a study published in 2021 4
- Patients with a higher baseline Expanded Disability Status Scale (EDSS) score may be at increased risk of disability worsening, as reported in a study published in 2024 2
- The treatment may not be effective for all patients, and alternative treatment options may need to be considered, as discussed in a review published in 2022 5
- Ocrelizumab has been shown to be effective in reducing disability progression in PPMS patients, but its effectiveness in improving quality of life and cognitive function is still being investigated, as mentioned in a study published in 2017 6
Overall, ocrelizumab is a valuable treatment option for PPMS patients, and its use should be considered in the context of individual patient needs and circumstances.