Ocrevus is a medication primarily used to treat multiple sclerosis (MS), including relapsing forms and primary progressive MS. While it can be effective in managing the disease, it carries a range of potential side effects that patients should be aware of.
One of the most common side effects of Ocrevus involves **infusion-related reactions**. These reactions can occur during the intravenous infusion or up to 24 hours afterward. Symptoms may include fever, chills, rash, itching, hives, skin redness, flushing, headache, dizziness, nausea, fatigue, throat irritation or pain, shortness of breath, swelling of the throat, low blood pressure, and in rare cases, severe allergic reactions like anaphylaxis. To reduce the risk of these reactions, patients are typically pre-treated with corticosteroids and antihistamines before each infusion.
Another frequent side effect is **upper respiratory tract infections**, such as colds or sinus infections. Patients may also experience other infections, including herpes virus-related infections like shingles or cold sores. Some of these infections can be serious, affecting the central nervous system or causing widespread skin and soft tissue problems. Because Ocrevus suppresses parts of the immune system, it increases vulnerability to infections, so monitoring and prompt treatment of infections are important.
**Fatigue and headache** are also commonly reported by patients receiving Ocrevus. These symptoms can vary in intensity but are generally manageable.
**Pain**, including back pain and muscle aches, may occur during treatment. Some patients report general body aches or discomfort.
There is a potential risk of **depression** or mood changes, which should be monitored by healthcare providers, especially if the patient has a history of mental health issues.
More serious but less common side effects include:
– **Progressive multifocal leukoencephalopathy (PML)**, a rare but serious brain infection caused by the JC virus, which can be life-threatening.
– **Reduction in immunoglobulins**, which are antibodies important for fighting infections, potentially leading to increased infection risk.
– **Malignancies**, or cancers, have been reported in some cases, so regular cancer screenings are recommended during treatment.
– **Immune-mediated colitis**, an inflammation of the colon caused by immune system reactions.
– **Liver injury**, which may present as symptoms like dark urine, jaundice (yellowing of the skin or eyes), or abdominal pain. If liver damage is suspected, discontinuation of Ocrevus may be necessary.
Because Ocrevus affects the immune system, it is important for patients to inform their healthcare providers about any signs of infection or unusual symptoms immediately. Patients are also advised to use effective contraception during treatment and for six months after the last infusion, as the effects on a developing fetus are not well understood. The impact on breastfeeding infants is also unknown.
In summary, while Ocrevus offers a valuable treatment option for MS, it comes with a spectrum of side effects ranging from mild infusion reactions and infections to rare but serious complications like PML and liver injury. Careful monitoring, pre-infusion medications, and open communication with healthcare providers help manage these risks effectively.
