The risk of infusion reactions with Ocrevus (ocrelizumab) is significant but manageable, especially with proper premedication and monitoring. Infusion reactions occur in about one-third to two-fifths of patients receiving Ocrevus intravenously, with the highest frequency during the first infusion. These reactions can range from mild to serious but are rarely fatal.
Infusion reactions typically happen during or within 24 hours after the infusion. Symptoms can include itching, rash, hives, redness of the skin, bronchospasm (tightening of airways), throat irritation or pain, difficulty breathing (dyspnea), swelling in the throat or larynx, flushing, low blood pressure (hypotension), fever (pyrexia), fatigue, headache, dizziness, nausea, rapid heartbeat (tachycardia), and in rare cases anaphylaxis—a severe allergic reaction that requires immediate medical attention.
In clinical trials for multiple sclerosis patients treated with intravenous Ocrevus who received premedication such as steroids and antihistamines to reduce these risks, about 34% to 40% experienced some form of infusion reaction. Serious infusion reactions occurred in approximately 0.3% of patients; some required hospitalization but none were fatal.
To minimize these risks:
– Patients are routinely given premedications before each infusion—typically corticosteroids like methylprednisolone and antihistamines—to help prevent or lessen reaction severity.
– Infusions are administered slowly under close medical supervision.
– Patients are monitored carefully during and after infusions for any signs of adverse effects.
– Patients should immediately report symptoms such as swelling around the face or throat, rash spreading over large areas of skin, difficulty breathing or swallowing.
Ocrevus is also available as a subcutaneous injection formulation called Ocrevus Zunovo which is given under the skin rather than intravenously. This method tends to have fewer systemic infusion-related side effects but still carries a risk for local injection site reactions like pain, redness discoloration at injection sites along with systemic symptoms such as headache and nausea.
Beyond acute infusion-related events:
– There is an increased risk for infections due to immune system suppression caused by Ocrevus targeting B cells involved in immune responses.
– Herpes virus infections including serious cases affecting central nervous system tissues have been reported postmarketing.
Patients receiving Ocrevus should be screened beforehand for active infections and monitored throughout treatment because infection risks may persist anytime during therapy.
In summary: while **infusion reactions** are relatively common when starting Ocrevus treatment—especially at first dose—they tend to be mild-to-moderate if managed properly through premedication protocols and vigilant monitoring by healthcare providers. Serious complications remain rare but require prompt recognition and intervention when they occur. This careful approach allows many people living with multiple sclerosis to benefit from this effective therapy while minimizing discomforts related to infusions themselves.
