If you stop taking Ocrevus (ocrelizumab), a medication used primarily to treat multiple sclerosis (MS), several important effects and risks can occur due to the way this drug works and its impact on the immune system.
Ocrevus is a monoclonal antibody that targets CD20-positive B cells, which are part of the immune system involved in MS disease activity. By depleting these B cells, Ocrevus helps reduce inflammation and slows disease progression. When you stop taking it, this suppression of B cells gradually reverses over several months as your immune system recovers. However, this recovery period can lead to a resurgence or worsening of MS symptoms because the underlying autoimmune activity may become active again without ongoing treatment.
One immediate concern after stopping Ocrevus is an increased risk of MS relapses or new neurological symptoms returning or worsening. Since Ocrevus controls disease activity by suppressing certain immune cells, discontinuation removes that control mechanism. Patients might experience more frequent flare-ups or progression in disability compared to when they were on therapy.
Another consideration is infection risk. While on Ocrevus, your immune system’s ability to fight infections is reduced because B cell depletion impairs normal immunity. This immunosuppressive effect does not end immediately upon stopping; it persists for some months afterward until B cell levels normalize. During this time after discontinuation, patients remain vulnerable to infections including serious ones caused by viruses like herpes simplex or varicella zoster.
Additionally, monitoring immunoglobulin levels (antibodies) before and after stopping treatment is important because low immunoglobulins can increase infection risk further and may require medical intervention such as intravenous immunoglobulin therapy if recurrent serious infections occur.
If someone misses a scheduled dose but plans to continue treatment later, it’s advised not to wait until the next planned infusion but rather administer the missed dose as soon as possible and then reset dosing intervals accordingly—this helps maintain better disease control without prolonged gaps that could trigger relapse.
Stopping Ocrevus also means losing its protective effects against certain complications associated with MS progression; therefore neurologists usually carefully weigh risks before recommending discontinuation unless there are compelling reasons such as severe side effects or life-threatening infusion reactions during administration.
In rare cases where patients develop severe adverse events like life-threatening infusion reactions during treatment with Ocrevus itself, permanent discontinuation becomes necessary along with supportive care measures for those reactions.
Overall, ceasing Ocrevus requires close medical supervision because:
– The return of active MS inflammation can cause new lesions in the brain/spinal cord.
– Immune function takes months to recover fully.
– Infection susceptibility remains elevated temporarily.
– Careful timing for restarting other therapies might be needed depending on individual circumstances.
Patients should never abruptly stop without consulting their healthcare provider who will consider alternative treatments or strategies tailored specifically for their condition status at that time. The goal is always balancing controlling MS while minimizing risks related both directly from medication cessation and from untreated disease activity itself.
