From the Guidelines
Ocrevus (ocrelizumab) maintenance therapy requires regular laboratory monitoring, including complete blood counts and liver function tests, to mitigate potential risks such as neutropenia and hepatotoxicity. The monitoring schedule should be individualized based on the patient's risk factors and medical history. According to the most recent guidelines, patients on immunosuppressive therapies, such as Ocrevus, should have regular monitoring of their blood work, including CBC counts and LFTs, to detect any potential abnormalities early on 1.
Key Monitoring Parameters
- Complete blood counts (CBC) to monitor for neutropenia and other blood cell abnormalities
- Liver function tests (LFTs) to monitor for hepatotoxicity
- Immunoglobulin levels to monitor for hypogammaglobulinemia
- Screening for hepatitis B virus and tuberculosis before starting treatment and periodically thereafter
- Monitoring for signs of infection and neurological symptoms, such as those associated with progressive multifocal leukoencephalopathy (PML)
Monitoring Schedule
The frequency of monitoring should be based on the individual patient's risk factors and medical history. However, as a general guideline, monitoring should occur at least every 3-4 months, with more frequent monitoring during the initial treatment period 1.
Importance of Monitoring
Regular laboratory monitoring is crucial to ensure the safe use of Ocrevus and to minimize the risk of potential complications. By monitoring for potential side effects and adjusting the treatment plan accordingly, healthcare providers can help optimize the benefits of Ocrevus while minimizing its risks.
From the FDA Drug Label
2.2 Assessments Prior to First Dose of OCREVUS ZUNOVO Hepatitis B Virus Screening Prior to initiating ocrelizumab treatment, perform Hepatitis B virus (HBV) screening. Serum Immunoglobulins Prior to initiating ocrelizumab treatment, perform testing for quantitative serum immunoglobulins
The maintenance labs to follow for Ocrevus include:
- Hepatitis B Virus Screening: prior to initiating treatment
- Serum Immunoglobulins: prior to initiating treatment 2
From the Research
Maintenance Labs for Ocrevus
To monitor the safety and efficacy of Ocrevus, several lab tests are recommended:
- Complete Blood Count (CBC) with differential count to monitor for potential hematologic effects 3
- Liver function tests (LFTs) to monitor for potential hepatotoxicity 4, 5
- Hepatitis B virus (HBV) screening to assess the risk of HBV reactivation 4, 5
- Anti-HBc antibody testing to identify patients at risk of HBV reactivation 4
Lab Monitoring Frequency
The frequency of lab monitoring may vary depending on the individual patient's risk factors and medical history:
- CBC with differential count: every 6 months 3
- LFTs: every 6 months 4, 5
- HBV screening: at baseline and periodically during treatment 4, 5
- Anti-HBc antibody testing: at baseline 4
Additional Considerations
Patients treated with Ocrevus should also be monitored for: