Drug Monograph

Ocrevus & Ocrevus Zunovo

ocrelizumab (IV); ocrelizumab and hyaluronidase-ocsq (SC)
CD20-Directed Cytolytic Monoclonal Antibody · Intravenous Infusion or Subcutaneous Injection
Pharmacokinetic Profile
Terminal Half-Life
26 days (IV); 20 days (SC)
Metabolism
Catabolic proteolysis (no CYP)
Central Volume of Distribution
2.78 L
Bioavailability
100% (IV); ~81% (SC)
Constant Clearance
0.17 L/day
Clinical Information
Drug Class
Anti-CD20 humanised IgG1 monoclonal antibody
Available Strengths
300 mg/10 mL IV vial; 920 mg/23 mL SC vial (Ocrevus Zunovo)
Route
IV infusion or SC injection (abdomen only)
Renal Adjustment
No dose adjustment (mild impairment studied)
Hepatic Adjustment
No adjustment in mild impairment; moderate-severe not studied
Pregnancy
Avoid; placental transfer of IgG
Lactation
No human milk data; minimal transfer expected
Schedule / Status
Prescription only (Rx); not a controlled substance
Generic / Biosimilar
No biosimilar approved (US/EU)
Boxed Warning
None; multiple class warnings (HBV, PML, infections, malignancy, colitis, liver injury)
Rx

Indications

Ocrelizumab is a B-cell-depleting therapy used in adults with multiple sclerosis. The intravenous formulation (Ocrevus) was first approved by the FDA on 28 March 2017. The subcutaneous co-formulation with hyaluronidase (Ocrevus Zunovo) received FDA approval on 13 September 2024. Ocrelizumab is the first and only disease-modifying therapy approved for primary progressive multiple sclerosis (PPMS) and is a high-efficacy option for relapsing forms of MS, where pivotal trials demonstrated superior reduction in annualised relapse rate and disability progression compared with subcutaneous interferon beta-1a.

IndicationApproved PopulationTherapy TypeStatus
Relapsing forms of multiple sclerosis (RMS) — including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive diseaseAdultsMonotherapyFDA Approved
Primary progressive multiple sclerosis (PPMS)AdultsMonotherapyFDA Approved

Ocrelizumab is approved as monotherapy and is not used in combination with other DMTs. Because it produces sustained B-cell depletion, switching to or from other immunomodulators requires careful consideration of washout periods, prior immunosuppressant exposure, and infection risk.

Off-Label Uses

Neuromyelitis optica spectrum disorder (NMOSD), AQP4-IgG seropositive — anti-CD20 therapy is sometimes used when approved agents (eculizumab, satralizumab, inebilizumab) are unavailable or cost-prohibitive. Evidence quality: low (small case series; rituximab data extrapolated).

MOG antibody-associated disease (MOGAD) — used in relapsing disease when first-line therapies fail. Evidence quality: very low (retrospective case series).

Refractory autoimmune encephalitis — occasional use as a B-cell-depleting strategy when rituximab is contraindicated. Evidence quality: very low (case reports).

Off-label use should follow shared decision-making and ideally be coordinated through neuroimmunology specialists.

Dose

Dosing

Ocrelizumab follows a fixed dose-by-scenario schedule rather than weight-based dosing. The hallmark of therapy is a six-monthly maintenance interval that aligns with the kinetics of B-cell repopulation. All infusions and injections require pre-medication to attenuate infusion or injection reactions, but the recommended pre-medication regimens differ between the intravenous and subcutaneous formulations.

Clinical ScenarioStarting DoseMaintenance DoseMaximum per CycleNotes
RMS or PPMS — first treatment course (IV)300 mg IV on Day 1, then 300 mg IV on Day 15600 mg total (split dose)Initial split dose lowers risk of infusion reaction with first exposure
Each 300 mg infusion runs over at least 2.5 h: start at 30 mL/h, titrate by 30 mL/h every 30 min to a maximum of 180 mL/h
RMS or PPMS — maintenance (IV, standard)600 mg IV every 6 months600 mg per cycleStandard infusion runs at least 3.5 h: start at 40 mL/h, titrate by 40 mL/h every 30 min to a maximum of 200 mL/h
First maintenance dose 6 months after Day 1; subsequent doses no sooner than 5 months apart
RMS or PPMS — maintenance (IV, shorter infusion)600 mg IV over ~2 hours600 mg per cycleApproved option for patients who tolerated previous infusions without serious reactions
RMS or PPMS — Ocrevus Zunovo (SC)920 mg SC every 6 months920 mg per cycleSingle 23 mL injection into the abdomen only, delivered over approximately 10 minutes
May be initiated as the first dose or used after switching from IV; contains 23,000 units of recombinant human hyaluronidase (PH20). Doses must be separated by at least 5 months
Missed doseAdminister as soon as possible; do not wait for the next planned cycleReset the schedule from the rescheduled dose
Do not double-dose

Pre-medication — IV Ocrevus

  • Methylprednisolone 100 mg IV (or an equivalent corticosteroid) approximately 30 minutes before each infusion.
  • Antihistamine (e.g., diphenhydramine) approximately 30–60 minutes before each infusion.
  • Antipyretic (e.g., paracetamol/acetaminophen) may be added at the prescriber’s discretion.

Pre-medication — Ocrevus Zunovo (SC)

  • Oral dexamethasone (or an equivalent corticosteroid) at least 30 minutes before each injection.
  • Oral antihistamine (e.g., desloratadine) at least 30 minutes before each injection.
  • Antipyretic (e.g., acetaminophen) may be added at the prescriber’s discretion.

Patient Observation Period

  • IV infusion: observe for at least 1 hour after each infusion completes.
  • SC injection (Ocrevus Zunovo): observe for at least 1 hour after the first injection; observe for at least 15 minutes after each subsequent injection.

Dose Modification for Infusion or Injection Reactions

  • Mild–moderate IV reaction: reduce the infusion rate to half the rate at onset; resume only after symptoms resolve.
  • Less severe SC reaction: interrupt the injection immediately; complete the dose at the prescriber’s discretion only after symptoms resolve.
  • Severe reaction (any route): immediately interrupt and manage with steroids, antihistamines, bronchodilators, or epinephrine as clinically indicated.
  • Life-threatening reaction: permanent discontinuation. Future ocrelizumab is contraindicated.

Special Populations

  • Renal impairment: mild impairment was represented in clinical trials with no significant change in pharmacokinetics; monoclonal antibodies are not renally cleared.
  • Hepatic impairment: mild impairment was represented in clinical trials with no significant change in pharmacokinetics; moderate-to-severe impairment has not been studied.
  • Elderly (≥55 years): data are limited; pivotal trials enrolled few patients above 55. Use the standard dose with heightened infection vigilance.
  • Pregnancy: avoid conception during therapy and for at least 6 months after the last dose. If pregnancy occurs, weigh continuation against MS disease activity in consultation with maternal-fetal medicine.
  • Paediatric patients: safety and efficacy in patients under 18 years have not been established; ocrelizumab is not currently approved for paediatric MS.
Clinical Pearl — Vaccination Window

Per the prescribing information, complete required live or live-attenuated vaccinations at least 4 weeks before initiating ocrelizumab and complete non-live vaccinations at least 2 weeks before initiation when possible. Live attenuated vaccines must be avoided during therapy and until B-cell recovery. After ocrelizumab is started, B-cell-dependent vaccine responses are markedly attenuated, so timing inactivated booster vaccines toward the end of the dosing interval (when B-cell counts are partially recovering) is a pragmatic option in selected patients. The median time to peripheral B-cell repopulation to baseline or the lower limit of normal in clinical studies was approximately 72 weeks (range 27–175 weeks) after the last dose.

PK

Pharmacology

Mechanism of Action

Ocrelizumab is a recombinant humanised IgG1 monoclonal antibody engineered to bind the CD20 antigen, a transmembrane phosphoprotein found on pre-B and mature B lymphocytes. CD20 is absent from haematopoietic stem cells, pro-B cells, and terminally differentiated plasma cells, which preserves long-term humoral immunity and the capacity to regenerate the B-cell pool after therapy ends.

Once bound, ocrelizumab depletes CD20-positive B cells through three complementary effector mechanisms: antibody-dependent cellular cytotoxicity, antibody-dependent cellular phagocytosis, and complement-dependent cytotoxicity. The clinical benefit in multiple sclerosis is thought to reflect interruption of B-cell-driven antigen presentation, cytokine signalling, and aberrant lymphoid follicle formation in the meninges, rather than direct effects on antibody production. Peripheral CD19+ B-cell counts (used as a surrogate marker because the drug interferes with the CD20 assay) fall within 14 days of the first dose and remain suppressed for the duration of dosing intervals; T-cell populations are largely preserved, distinguishing ocrelizumab from broader immunosuppressants.

ADME Profile

ParameterValueClinical Implication
AbsorptionIV: 100% bioavailable. SC (Ocrevus Zunovo): estimated absolute bioavailability approximately 81%; mean Cmax 132 µg/mL reached at approximately 4 days post-injection. With IV: mean Cmax 212 µg/mL (600 mg) and 141 µg/mL (initial 2 × 300 mg)SC formulation provides comparable systemic exposure with shorter administration time; useful for outpatients and where venous access is poor
DistributionCentral volume of distribution 2.78 L; peripheral volume 2.68 L; intercompartment clearance ~0.29 L/day. Largely confined to extracellular fluid; placental transfer occurs via Fc-mediated transport, especially in the third trimesterNegligible CNS penetration limits direct effects on CNS-resident B cells; placental transfer mandates planned conception and contraception counselling
MetabolismCatabolised to small peptides and amino acids via the reticuloendothelial system; no hepatic CYP450 metabolism. PK is essentially linear and dose-proportional between 400 mg and 2,000 mgNo CYP-mediated drug interactions; pharmacokinetics is not affected by drugs altering hepatic enzymes
EliminationConstant clearance 0.17 L/day; initial time-dependent clearance 0.05 L/day declining with a half-life of 33 weeks. Terminal elimination half-life is 26 days for IV and 20 days for SC; no renal excretionSustained B-cell depletion supports the 6-month dosing interval; immunosuppressive effects persist for months after the last dose, relevant for vaccination, pregnancy planning, and switching DMTs

Population pharmacokinetic analyses identified body weight as the main covariate affecting clearance, but the effect size is small enough that fixed dosing achieves acceptable exposure across the licensed weight range. Anti-drug antibodies have been detected at very low frequency and have not been associated with reduced efficacy or increased reactions.

SE

Side Effects

The safety profile of ocrelizumab is dominated by infusion-related (or injection-related) reactions and increased rates of common infections, particularly upper respiratory tract infections. Frequencies below are drawn from the OPERA I, OPERA II, ORATORIO, and OCARINA II trials and the integrated FDA prescribing information for Ocrevus and Ocrevus Zunovo.

≥10% Very Common
Adverse EffectIncidenceClinical Note
Upper respiratory tract infection~40% (RMS); ~49% (PPMS)Higher rate in the PPMS cohort; usually mild and self-limited
Infusion reactions (RMS, pooled OPERA)34.3%Most common with the first infusion (~27% of patients on dose 1); incidence drops with subsequent infusions; pruritus, rash, throat irritation, flushing, tachycardia
Infusion reactions (PPMS, ORATORIO)39.9%Slightly higher than RMS; serious IRRs occurred in 0.3% of IV-treated patients
Injection reactions (Ocrevus Zunovo, OCARINA II)~49% (first injection)Predominantly local (erythema, pain, swelling, pruritus); incidence of local reactions on injections 2–4 ranged from 31% to 43%; systemic reactions on subsequent injections 3% to 7%
Skin and skin-structure infections~14% (PPMS)Cellulitis and folliculitis predominate
Decreased serum immunoglobulins (IgG < LLN over multiple cycles)Cumulative; rises with treatment durationPooled long-term data link decreased IgG with increased serious infection rates
1–10% Common
Adverse EffectIncidenceClinical Note
Lower respiratory tract infection (bronchitis, pneumonia)~8% (RMS); ~10% (PPMS)Higher rate in PPMS; assess promptly with imaging if symptoms persist
Herpes virus infections (oral, genital, zoster)5.9% (RMS pooled)Typically uncomplicated; treat with standard antivirals; rare severe genital herpes reported
Depression~8%Screen with PHQ-9 or similar at follow-up visits; depression is a common comorbidity in MS overall
Cough~7%Often part of URI; persistent cough warrants chest imaging
Diarrhoea~6%Usually mild and self-limited; new persistent or bloody diarrhoea should prompt evaluation for immune-mediated colitis
Pain in extremity~5%Non-specific; consider underlying neuropathic cause
Peripheral oedema~4%Generally mild
Back pain (PPMS)~14%Often reflects underlying disease; consider non-pharmacological management
Serious Serious Adverse Effects (regardless of frequency)
Adverse EffectEstimated FrequencyTypical OnsetRequired Action
Severe / life-threatening infusion reaction (anaphylaxis, bronchospasm, hypotension)0.3% of IV-treated patientsWithin minutes of infusion start; usually first doseStop infusion immediately; manage anaphylaxis (epinephrine, steroids, fluids); permanent discontinuation
Progressive multifocal leukoencephalopathy (PML)Rare (post-marketing)Months to years; higher risk with prior natalizumab or other immunosuppressant exposureHold drug for any new neurological deficit; obtain MRI and CSF JCV PCR; permanent discontinuation if confirmed
Hepatitis B reactivation (including fulminant hepatitis)RareWeeks to months after initiation in HBV carriers or those with resolved infectionScreen all patients before starting (HBsAg, total anti-HBc); consult hepatology for positive results; antiviral prophylaxis often required
Serious bacterial, viral, or opportunistic infection~1.3% (OPERA RMS); ~6% (ORATORIO PPMS)Any time during therapy; risk rises with prolonged hypogammaglobulinaemiaHold further dosing; treat aggressively; monitor IgG and consider IVIG replacement if recurrent
BabesiosisRare (post-marketing)Variable; typically following tick exposureConsider in immunosuppressed patients with febrile illness and haemolysis; thick/thin smear and PCR; treat per ID guidance
Immune-mediated colitisRare (post-marketing)Weeks to years from initiationRefer to gastroenterology for new persistent diarrhoea, abdominal pain, or rectal bleeding; some cases require systemic corticosteroids or surgery
Liver injury (without viral hepatitis)Rare (post-marketing class effect)VariableObtain baseline ALT, AST, alkaline phosphatase, bilirubin; monitor as clinically indicated; investigate fatigue, anorexia, jaundice, dark urine, or right-upper-quadrant pain promptly
Hypogammaglobulinaemia with serious infectionIncreases with cumulative cyclesTypically after several years of therapyMonitor IgG, IgM, IgA before each infusion; involve immunology if IgG persistently below normal with recurrent infection
Malignancy — breast cancer signal6 of 781 ocrelizumab-treated females (controlled trials) vs 0 of 668 in REBIF/placeboVariable; long-term post-marketing rates remain consistent with background population estimatesMaintain age-appropriate breast cancer screening; report new diagnoses to manufacturer registry
Other malignancies (overall)0.5% (OPERA pooled, neoplasms); ~0.49 per 100 patient-years (long-term integrated safety)VariableContinue routine cancer surveillance per population guidelines
Discontinuation Discontinuation Rates
RMS — OPERA I / II
3.2% / 3.8% vs ~6% IFN beta-1a (pooled)
Top reasons: infusion reactions, infections, malignancy
PPMS — ORATORIO
4.1% vs 3.3% placebo
Top reasons: infusion reactions, infections, malignancy
Reason for DiscontinuationIncidenceContext
All-cause AE-driven discontinuation (long-term integrated safety, up to 7 years)3.2% (181/5,680 patients)Pooled across 11 clinical trials (18,218 patient-years); rate stable over time
Infusion reaction~1%Almost always after the first or second infusion; rate falls dramatically with subsequent cycles
Malignancy (mandatory discontinuation per protocol)<1%Includes the breast cancer signal in pivotal trials
Serious infection<1%Pneumonia or recurrent skin/soft-tissue infection are the most frequent triggers
Hypogammaglobulinaemia with infections<1%Cumulative effect of multiple cycles; some patients managed with extended dosing intervals rather than discontinuation
Patient choice (pregnancy planning, treatment fatigue)~1–2%Long half-life requires planning at least 6 months before conception
Management Priority — Infusion Reactions

Reactions are most common with the first infusion (approximately 27% of patients in OPERA pooled analysis). Standard pre-medication with IV methylprednisolone, an antihistamine, and (optionally) an antipyretic markedly reduces severity. Serious IV infusion reactions occurred in 0.3% of patients in MS trials; there were no fatal infusion reactions. For mild-to-moderate IV reactions, halve the infusion rate; for severe reactions, interrupt the infusion and resume only after symptoms resolve, then at half the previous rate. Document the reaction characteristics in detail because subsequent cycles often proceed uneventfully once the patient is established.

Int

Drug Interactions

Ocrelizumab is not metabolised by cytochrome P450 enzymes, so classic pharmacokinetic interactions are minimal. The clinically relevant interactions are pharmacodynamic — additive immunosuppression, blunted vaccine responses, and altered infection risk when combined with other immune-modulating agents.

Major Live attenuated vaccines (MMR, varicella, yellow fever, oral polio, BCG, intranasal influenza)
MechanismProfound B-cell depletion plus theoretical risk of vaccine-strain replication in an immunosuppressed host
EffectRisk of disseminated vaccine-strain infection; markedly reduced antibody response
ManagementAvoid during therapy and until B-cell recovery; complete required live vaccines at least 4 weeks before initiation
FDA PI
Major Other immunosuppressants (mycophenolate, azathioprine, methotrexate, cyclophosphamide, anti-CD20 agents, S1P modulators)
MechanismAdditive lymphocyte suppression; cumulative depletion across multiple immune compartments
EffectMarkedly increased risk of opportunistic infection, including PML; higher risk of hypogammaglobulinaemia
ManagementAvoid combination; if switching DMTs, allow appropriate washout based on the prior agent (e.g., wait for confirmed lymphocyte recovery after fingolimod)
FDA PI
Major Natalizumab
MechanismSequential profound immune modulation; potential carryover JC virus reactivation risk
EffectPost-marketing PML cases reported in patients with recent natalizumab exposure transitioning to anti-CD20 therapy
ManagementBridge carefully; check JCV antibody index before switching; monitor for new neurological symptoms
Case reports
Major Belimumab and other B-cell-targeted biologics
MechanismOverlapping B-cell suppression
EffectProfound and prolonged B-cell aplasia, hypogammaglobulinaemia
ManagementAvoid concurrent use; sequential use only with documented B-cell recovery if clinically warranted
Manufacturer
Moderate Inactivated vaccines (influenza, pneumococcal, COVID-19, hepatitis B)
MechanismB-cell depletion blunts the humoral response; T-cell responses are largely preserved
EffectReduced seroconversion rates, especially to neoantigens; some clinical protection persists via T-cell immunity
ManagementComplete non-live vaccines at least 2 weeks before initiation per the PI; for ongoing therapy, vaccinate toward the end of the dosing interval where feasible; document seroconversion when clinically important (e.g., hepatitis B)
FDA PI
Moderate Corticosteroids (chronic systemic, beyond pre-medication)
MechanismAdditive immunosuppression beyond the protocolised pre-medication
EffectHigher infection risk; potentially blunted vaccine response
ManagementUse the lowest effective steroid dose; avoid prolonged daily prednisolone unless clinically essential
FDA PI
Moderate TNF-alpha inhibitors and other biologics
MechanismCombined cytokine and B-cell suppression
EffectIncreased risk of serious infection and tuberculosis reactivation
ManagementAvoid combination unless directed by a specialist; screen for latent TB before any concurrent use
Lexicomp
Minor Drugs metabolised by CYP enzymes (general)
MechanismTheoretical effect of cytokine modulation on hepatic CYP expression
EffectNo clinically meaningful changes documented to date
ManagementRoutine concomitant medication review; no specific dose adjustment required
Manufacturer
Mon

Monitoring

Monitoring focuses on a structured baseline workup before initiation, surveillance for infection and immunoglobulin depletion during therapy, and vigilance for late complications such as malignancy and PML. The current Ocrevus Zunovo prescribing information requires baseline HBV serology, quantitative serum immunoglobulins, and liver function tests (ALT, AST, alkaline phosphatase, bilirubin) before initiation; these expectations apply to the IV formulation as well in clinical practice.

  • Hepatitis B serology Before first dose
    Routine
    HBsAg and total anti-HBc are mandatory before initiation. Anti-HBs is helpful to confirm prior vaccination response. Patients with active or resolved hepatitis B require hepatology input and often antiviral prophylaxis.
  • Quantitative immunoglobulins (IgG, IgM, IgA) Baseline, then before each infusion or injection
    Routine
    The trend over time is more informative than a single value. IgM falls earliest. Persistent IgG below the lower limit of normal — especially with recurrent infections — prompts immunology referral and consideration of extended dosing intervals or IVIG replacement.
  • Liver function tests (ALT, AST, ALP, bilirubin) Baseline, then as clinically indicated
    Routine
    Required at baseline per the current PI given post-marketing reports of clinically significant liver injury without viral hepatitis on anti-CD20 therapies; investigate fatigue, anorexia, jaundice, or right-upper-quadrant pain promptly.
  • CBC with differential Before each infusion (clinical practice)
    Routine
    Monitor for unexpected cytopenias and lymphopenia. Severe neutropenia (rare) warrants temporary withholding of further dosing.
  • Pregnancy testing Before each infusion in patients of childbearing potential
    Routine
    Effective contraception should be used during therapy and for 6 months after the last dose. Counsel about pregnancy planning at every visit.
  • Active infection assessment Before each dose
    Routine
    Per the PI, determine whether there is an active infection before each dose; delay administration until any active infection has resolved.
  • Vital signs during administration Throughout administration and during the post-dose observation window
    Routine
    Document blood pressure, pulse, oxygen saturation, and any new symptoms. Observe for at least 1 hour after each IV infusion, after the first SC injection, and for at least 15 minutes after subsequent SC injections.
  • Infection symptom review Every visit; safety-net all patients between cycles
    Routine
    Prompt evaluation of fever, productive cough, dysuria, skin breakdown, or persistent diarrhoea. Lower threshold for imaging and cultures than in immunocompetent patients.
  • Brain MRI Annually or per institutional MS protocol
    Routine
    Assess MS disease activity (new T2 or gadolinium-enhancing lesions). New atypical lesions should also raise suspicion for PML and prompt urgent specialist review.
  • Cancer screening (age-appropriate, including breast) Per population-based guidelines
    Routine
    Maintain mammography, cervical screening, and colorectal screening on schedule. The numerical breast cancer signal in pivotal trials warrants reinforcement of screening adherence.
  • Hepatitis B PCR / DNA If anti-HBc positive at baseline
    Trigger-based
    Periodic monitoring (every 3–6 months) is appropriate for patients with prior hepatitis B exposure receiving antiviral prophylaxis. Hepatology should guide frequency.
  • CSF JC virus PCR / urgent brain MRI Any new neurological symptom not attributable to MS
    Trigger-based
    Hold further dosing pending evaluation. PML should be specifically excluded with MRI and CSF testing in patients with prior natalizumab exposure or new atypical white-matter lesions.
  • Vaccine antibody titres After major immunisation events (e.g., hepatitis B series)
    Trigger-based
    Document seroconversion where vaccine response is clinically important (hepatitis B in healthcare workers, travel vaccines). Anticipate reduced response and consider repeat dosing.
  • GI evaluation If new persistent diarrhoea, abdominal pain, or rectal bleeding
    Trigger-based
    Refer to gastroenterology to rule out immune-mediated colitis (now in the PI Warnings and Precautions section based on post-marketing reports).
CI

Contraindications & Cautions

Absolute Contraindications

  • Active hepatitis B virus infection — confirmed by positive HBsAg and anti-HBV testing; due to risk of severe reactivation and fulminant hepatitis.
  • History of life-threatening hypersensitivity reaction to ocrelizumab or any component of the formulation, including prior anaphylaxis or anaphylactoid response.
  • Active malignancy at the time of proposed initiation — defer until oncology clearance.
  • Active serious infection — defer until the infection has resolved.
  • Confirmed PML — permanent contraindication.

Relative Contraindications (Specialist Input Recommended)

  • Resolved hepatitis B infection (HBsAg-negative, anti-HBc positive) — requires hepatology co-management and an antiviral prophylaxis decision.
  • Recent natalizumab exposure — JCV antibody index and structured washout planning before switching, given documented PML reports during this transition.
  • Significant baseline hypogammaglobulinaemia — immunology assessment to determine an acceptable IgG threshold and the need for replacement therapy.
  • Pregnancy or planned conception within 6 months — discuss with maternal-fetal medicine; the long half-life means the drug remains biologically active well into pregnancy if administered shortly before conception.
  • History of significant hepatic disease — given post-marketing reports of liver injury on anti-CD20 therapies; obtain baseline LFTs and hepatology input as needed.
  • History of inflammatory bowel disease — post-marketing reports of new or worsening colitis on anti-CD20 therapies warrant gastroenterology input.

Use with Caution

  • Older adults (≥55 years) — limited trial data; greater absolute infection risk.
  • Patients with prior or current chronic infections (HIV, hepatitis C, latent tuberculosis) — screen and manage appropriately before initiation.
  • Cardiovascular comorbidity — pre-medication corticosteroids and the infusion-related fluid load may exacerbate uncontrolled hypertension or heart failure.
  • Significant respiratory disease — increased vulnerability to lower respiratory tract infections; consider risk-benefit and pulmonary input.
  • Patients with poor venous access — the SC formulation (Ocrevus Zunovo) may be preferable.
FDA Class-Wide Regulatory Warning Hepatitis B Virus Reactivation

B-cell-depleting antibodies, including ocrelizumab, can cause hepatitis B virus reactivation in patients with chronic or resolved infection, occasionally resulting in fulminant hepatitis, hepatic failure, and death. All patients must undergo HBV screening (HBsAg and total anti-HBc) before initiation. Patients with positive results require infectious disease or hepatology consultation, and many will need antiviral prophylaxis throughout therapy and for at least 6–12 months after the last dose.

FDA Class-Wide Regulatory Warning Progressive Multifocal Leukoencephalopathy (PML)

PML, an opportunistic JC virus infection of the brain, has been reported in patients receiving anti-CD20 therapies, including in the post-marketing setting for ocrelizumab. Risk is highest in patients with prior immunosuppressant exposure, especially natalizumab. Hold ocrelizumab and obtain MRI plus CSF JC virus PCR for any new or worsening neurological, cognitive, or behavioural sign that cannot be explained by MS itself. Permanently discontinue if PML is confirmed.

FDA Warnings and Precautions Immune-Mediated Colitis and Liver Injury

Immune-mediated colitis was added to the prescribing information in August 2022 based on post-marketing reports, some of which required hospitalisation, systemic corticosteroids, or surgical intervention. Clinically significant liver injury without viral hepatitis was added as a class warning for anti-CD20 MS therapies in 2025. Investigate new persistent diarrhoea, abdominal pain, rectal bleeding, jaundice, dark urine, fatigue, anorexia, nausea, or right-upper-quadrant pain promptly with appropriate referral.

Pt

Patient Counselling

Purpose of Therapy

Ocrelizumab is a long-acting antibody that lowers the number of B cells, a type of white blood cell that contributes to multiple sclerosis. By depleting these cells, it reduces relapses, slows the progression of disability, and limits the development of new MRI lesions. It does not cure MS, but it offers high-efficacy disease control with infrequent dosing.

How to Take

Treatment begins with two intravenous infusions two weeks apart. After that, a single infusion is given every six months, taking around two to three and a half hours depending on the rate. A subcutaneous version (Ocrevus Zunovo) is available for some patients and takes about ten minutes, given as a single injection into the abdomen. Pre-medication is given before every dose to reduce reactions: with intravenous treatment this is an IV steroid plus an antihistamine; with the subcutaneous injection this is oral steroid and oral antihistamine taken at least 30 minutes before. Patients are observed for at least one hour after each IV infusion and after the first SC injection. Patients should arrive well-hydrated and having eaten, and should have someone available to drive home if they feel drowsy.

Reactions during infusion or injection
Tell patient Mild itching, throat tickle, flushing, or a brief drop in blood pressure can occur, especially with the first dose. Pre-medication greatly reduces this. The infusion can usually be slowed and restarted, and most people tolerate later cycles without any reaction. Reactions can occur up to 24 hours after a dose.
Call prescriber Difficulty breathing, swelling of the lips or tongue, severe rash, chest tightness, or fainting during or after a dose — call emergency services immediately.
Increased risk of infection
Tell patient Colds, sinus infections, urinary tract infections, and skin infections are more common during therapy. Hand hygiene, prompt dental care, and seasonal vaccines (non-live) help reduce risk.
Call prescriber Fever above 38.0 °C, productive cough lasting more than a few days, painful red skin patches, persistent diarrhoea, or symptoms of shingles (a painful rash on one side of the body) need same-day review.
Vaccinations
Tell patient Flu shots, COVID-19 vaccines, pneumonia vaccines, and hepatitis B vaccines are still recommended but may work less well during therapy. Live vaccines such as MMR, yellow fever, and the nasal-spray flu vaccine must not be given during therapy and should ideally be completed at least four weeks before starting.
Call prescriber Before any travel involving live-vaccine requirements (e.g., yellow fever for certain countries) — planning ahead is essential.
Pregnancy and breastfeeding
Tell patient Effective contraception is needed during therapy and for at least six months after the last dose. Plan pregnancies in advance with the neurology team; the drug remains biologically active in the body for many months. Limited evidence so far suggests very little ocrelizumab passes into breast milk, but each case should be discussed individually.
Call prescriber If pregnancy is planned, suspected, or confirmed at any point during therapy. Do not stop other medications without advice.
New neurological symptoms
Tell patient Some new symptoms may reflect MS itself, but a small number of patients can develop a rare brain infection called PML. Any new symptom that feels different from previous MS attacks deserves prompt evaluation.
Call prescriber New confusion, personality change, problems with memory or speech, persistent clumsiness, or visual changes that are not typical of past relapses — contact the MS team within 24 hours.
Liver and gut symptoms
Tell patient Rare but serious problems with the bowels (colitis) or the liver have been reported on anti-CD20 therapies. Blood tests will check liver function before starting and as needed during therapy.
Call prescriber New persistent diarrhoea, abdominal pain, blood in the stool, yellowing of the skin or eyes, dark urine, unusual tiredness, loss of appetite, or pain in the upper right abdomen.
Cancer screening and breast health
Tell patient Routine cancer screening (mammograms, cervical screening, colon screening) should continue on schedule. A small numerical increase in breast cancer was seen in trials, so screening is particularly important.
Call prescriber Any new breast lump, breast skin change, unexplained weight loss, persistent rectal bleeding, or unusual vaginal bleeding — arrange evaluation promptly.
Long-term immune function
Tell patient Blood tests will track antibody levels before each dose. Some patients develop low antibody levels after several years and may need extended dosing intervals or additional treatment to support the immune system.
Call prescriber Recurring infections (more than three or four per year) or any infection that is severe or unusually slow to clear up.
Ref

Sources

Regulatory (PI / SmPC)
  1. Genentech, Inc. OCREVUS (ocrelizumab) Prescribing Information. South San Francisco, CA. https://www.gene.com/download/pdf/ocrevus_prescribing.pdf Primary US labelling for the IV formulation; authoritative source for indications, IV dosing, ADME, contraindications, warnings, and adverse reaction tables.
  2. Genentech, Inc. OCREVUS ZUNOVO (ocrelizumab and hyaluronidase-ocsq) Prescribing Information. South San Francisco, CA. https://www.gene.com/download/pdf/ocrevus_zunovo_prescribing.pdf US labelling for the SC formulation; source for the 920 mg SC dose, abdomen-only injection site, oral pre-medication regimen, ~81% bioavailability, 20-day terminal half-life, and updated colitis and liver injury warnings.
  3. European Medicines Agency. Ocrevus: EPAR — Product Information. https://www.ema.europa.eu/en/medicines/human/EPAR/ocrevus European Summary of Product Characteristics; cross-checked for any divergence from US labelling on dosing schedule and warnings.
  4. US Food and Drug Administration. Ocrevus Zunovo (ocrelizumab and hyaluronidase-ocsq) full prescribing information (NDA 761371). 13 September 2024. https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/761371s000lbl.pdf Initial US approval document for the SC formulation; confirms 920 mg SC every 6 months, abdomen-only administration, and pre-medication requirements.
Key Clinical Trials
  1. Hauser SL, Bar-Or A, Comi G, et al. Ocrelizumab versus interferon beta-1a in relapsing multiple sclerosis. N Engl J Med. 2017;376(3):221–234. https://doi.org/10.1056/NEJMoa1601277 OPERA I and OPERA II pivotal trials that established ocrelizumab’s superiority over IFN beta-1a for relapsing MS; primary source for RMS efficacy and adverse event rates.
  2. Montalban X, Hauser SL, Kappos L, et al. Ocrelizumab versus placebo in primary progressive multiple sclerosis. N Engl J Med. 2017;376(3):209–220. https://doi.org/10.1056/NEJMoa1606468 ORATORIO trial; the first DMT to demonstrate slowing of disability progression in PPMS, supporting the PPMS indication and the malignancy and infection rates discussed.
  3. Mayer L, Kappos L, Racke MK, et al. Ocrelizumab infusion experience in patients with relapsing and primary progressive multiple sclerosis: results from the phase 3 randomized OPERA I, OPERA II, and ORATORIO studies. Mult Scler Relat Disord. 2019;30:236–243. https://doi.org/10.1016/j.msard.2019.01.044 Pooled IRR analysis providing the 34.3% (RMS) and 39.9% (PPMS) infusion reaction frequencies cited in the side effects section.
  4. Hauser SL, Kappos L, Arnold DL, et al. Five years of ocrelizumab in relapsing multiple sclerosis: OPERA studies open-label extension. Neurology. 2020;95(13):e1854–e1867. https://doi.org/10.1212/WNL.0000000000010376 Long-term efficacy extension; supports durability of effect on relapses and confirmed disability progression.
  5. Wolinsky JS, Arnold DL, Brochet B, et al. Long-term follow-up from the ORATORIO trial of ocrelizumab for primary progressive multiple sclerosis: a post-hoc analysis from the ongoing open-label extension of the randomised, placebo-controlled, phase 3 trial. Lancet Neurol. 2020;19(12):998–1009. https://doi.org/10.1016/S1474-4422(20)30342-2 Extension data demonstrating sustained reduction in disability progression in PPMS over 6.5 years.
  6. Hauser SL, Kappos L, Bar-Or A, et al. Safety of ocrelizumab in patients with relapsing and primary progressive multiple sclerosis. Neurology. 2021;97(16):e1546–e1559. https://doi.org/10.1212/WNL.0000000000012700 Integrated long-term safety analysis through 7 years (5,680 patients, 18,218 patient-years); source for cumulative discontinuation, serious infection, and malignancy rates.
  7. Newsome SD, Krzystanek E, Selmaj KW, et al. Subcutaneous ocrelizumab in patients with multiple sclerosis: results of the phase 3 OCARINA II study. Neurology. 2025;104(9):e213574. https://doi.org/10.1212/WNL.0000000000213574 Phase 3 PK-bridging trial supporting non-inferiority of 920 mg SC versus 600 mg IV; pivotal evidence behind the Ocrevus Zunovo approval.
  8. Newsome SD, Goldstick L, Robertson DS, et al. Subcutaneous ocrelizumab in multiple sclerosis: results of the phase 1b OCARINA I study. Ann Clin Transl Neurol. 2024;11(12):3215–3226. https://doi.org/10.1002/acn3.52229 Dose-finding study that selected 920 mg SC as the dose for the phase 3 OCARINA II trial.
Guidelines
  1. Rae-Grant A, Day GS, Marrie RA, et al. Practice guideline recommendations summary: disease-modifying therapies for adults with multiple sclerosis. Neurology. 2018;90(17):777–788. https://doi.org/10.1212/WNL.0000000000005347 American Academy of Neurology guideline (reaffirmed 2024) positioning ocrelizumab among DMT options for relapsing and progressive disease.
  2. Montalban X, Gold R, Thompson AJ, et al. ECTRIMS/EAN guideline on the pharmacological treatment of people with multiple sclerosis. Eur J Neurol. 2018;25(2):215–237. https://doi.org/10.1111/ene.13536 European treatment guideline jointly published in Multiple Sclerosis Journal; framework for selecting high-efficacy therapy in active RMS and the only DMT recommendation for PPMS at time of publication.
  3. National Institute for Health and Care Excellence. Ocrelizumab for treating primary progressive multiple sclerosis (TA585). 12 June 2019. https://www.nice.org.uk/guidance/ta585 UK technology appraisal restricting reimbursed use to early PPMS with imaging features of inflammatory activity; informs the relative contraindication and patient-selection discussion.
Mechanistic / Basic Science
  1. Hauser SL. The Charcot Lecture | beating MS: a story of B cells, with twists and turns. Mult Scler J. 2015;21(1):8–21. https://doi.org/10.1177/1352458514561911 Conceptual framework for B-cell-driven MS pathology; supports the mechanism-of-action description.
  2. Klein C, Lammens A, Schäfer W, et al. Epitope interactions of monoclonal antibodies targeting CD20 and their relationship to functional properties. MAbs. 2013;5(1):22–33. https://doi.org/10.4161/mabs.22771 Comparative epitope and effector function analysis explaining ADCC-predominant mechanism of ocrelizumab versus other anti-CD20 antibodies.
Pharmacokinetics / Special Populations
  1. Gibiansky E, Petry C, Mercier F, et al. Ocrelizumab in relapsing and primary progressive multiple sclerosis: pharmacokinetic and pharmacodynamic analyses of OPERA I, OPERA II and ORATORIO. Br J Clin Pharmacol. 2021;87(6):2511–2520. https://doi.org/10.1111/bcp.14658 Population PK/PD analysis underpinning the 26-day terminal half-life, 0.17 L/day clearance, 2.78 L central volume, and weight-covariate findings reported in the ADME table.
  2. Vukusic S, Carra-Dalliere C, Ciron J, et al. Pregnancy and multiple sclerosis: 2022 recommendations from the French multiple sclerosis society. Mult Scler J. 2023;29(1):11–36. https://doi.org/10.1177/13524585221129472 Practical guidance on managing DMTs including ocrelizumab around conception and lactation; informs the contraindications and counselling sections.
  3. Ciotti JR, Valtcheva MV, Cross AH. Effects of MS disease-modifying therapies on responses to vaccinations: a review. Mult Scler Relat Disord. 2020;45:102439. https://doi.org/10.1016/j.msard.2020.102439 Synthesis of vaccine response data across DMTs; supports the timing recommendations for inactivated and live vaccines on ocrelizumab.