Products
Ocrelizumab was approved in many countries and in the United States in 2017 and in the EU in 2018 as an infusion concentrate (Ocrevus).
Structure and properties
Ocrelizumab is a humanized IgG1 monoclonal antibody with a molecular mass of 145 kDa. It is produced by biotechnological methods. Ocrelizumab is the successor agent to rituximab (MabThera), to which it is structurally and pharmacologically related. Rituximab is used for rheumatoid arthritis therapy, among other indications, and does not have approval for MS.
Effects
Ocrelizumab (ATC L04AA36) has selective immunosuppressive and cytotoxic properties. The antibody binds to B cells with the CD20 antigen on the surface and causes cell disruption. This results in B cell depletion. B cells play an important role in myelin and nerve cell damage. They activate pro-inflammatory T cells, secrete pro-inflammatory cytokines, and are involved in the formation of autoantibodies against myelin. Ocrelizumab does not bind to stem cells, plasma cells, or pro-B cells because they do not carry the CD20 antigen on the cell surface. The half-life is 26 days. ADCC: Antibody-Dependent Cell-Mediated Cytotoxicity Ocrelizumab reduces the number of relapses and foci of inflammation in the brain in the relapsing-remitting form and delays the progression of disability in primary progressive disease.
Indications
- Active relapsing forms of multiple sclerosis (RRMS).
- Primary progressive multiple sclerosis (PPMS).
Dosage
According to the professional information. The drug is administered as an intravenous infusion.
Contraindications
- Hypersensitivity
- Severe heart failure (NYHA stage IV)
- Severe immunosuppression, treatment with immunosuppressants.
- Presence of an active infection
- Existing active malignant disease (with the exception of cutaneous basal cell carcinoma).
- Start of therapy during pregnancy
For complete precautions, see the drug label.
Interactions
Drug-drug interactions are possible with immunosuppressants.
Adverse effects
The most common potential adverse effects include infusion-related reactions and respiratory infections. As an immunosuppressive agent, ocrelizumab may promote the development of infectious diseases.
