What Should I Tell My Healthcare Provider Before Using Ocrevus
Before receiving Ocrevus, tell your healthcare provider about all of your medical conditions, including if you:
- have ever taken, take, or plan to take medicines that affect your immune system, or other treatments for MS. These medicines could increase your risk of getting an infection.
- have ever had hepatitis B or are a carrier of the hepatitis B virus.
- have had a recent vaccination or are scheduled to receive any vaccinations.
- You should receive any required live or live-attenuated vaccines at least 4 weeks before you start treatment with Ocrevus. You should not receive live or live-attenuated vaccines while you are being treated with Ocrevus and until your healthcare provider tells you that your immune system is no longer weakened.
- When possible, you should receive any non-live vaccines at least 2 weeks before you start treatment with Ocrevus. If you would like to receive any non-live vaccines, including the seasonal flu vaccine, while you are being treated with Ocrevus, talk to your healthcare provider.
- If you have a baby and you received Ocrevus during your pregnancy, it is important to tell your babys healthcare provider about receiving Ocrevus so they can decide when your baby should be vaccinated.
Breast Cancer Drug Shows Potential To Repair Myelin
Researchers at the University of Cambridge have found a new way to repair myelin using a well-established treatment for breast cancer.
Tamoxifen has been used to treat breast cancer since the early 1970s, but research has revealed some previously unknown benefits of the treatment.
Dr Mark Kotter, who led the project, said:
Were very excited about our findings. We looked at six existing drugs for a range of conditions as part of our work. What we discovered was that Tamoxifen can enhance myelin repair in MS by encouraging the brains own stem cells to regenerate myelin.
Does Ocrevus Cause Weight Gain Or Weight Loss
Keep in mind that Ocrevus may cause edema in the arms or legs, and this can lead to a small amount of weight gain. If you have edema with Ocrevus, talk with your doctor about ways to ease this side effect. They may prescribe a medication to help reduce your swelling.
If youre concerned about weight changes while taking Ocrevus, talk with your doctor. They can recommend ways to help maintain a healthy weight for you.
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Ocrevus And Other Drugs That Weaken Your Immune System
While taking Ocrevus, you shouldnt take other medications that may weaken your immune system.
This is because Ocrevus weakens your immune system. If you take it with another medication that also has this effect, your immune system may get too weak. This could make your body unable to fight infections.
Other MS medications may also affect your immune system, so you should talk with your doctor if youre switching from another MS medication to Ocrevus.
They may want you to wait to start Ocrevus. This is because some MS medications may last weeks or months in your body. Your doctor will be able to help you determine how long to wait between stopping your old MS medication and starting Ocrevus.
Examples of MS medications that have an effect on your immune system for a long period of time include:
Talk with your doctor about any other medications youre taking before you start Ocrevus.
Upper And Lower Respiratory Infections
Upper and lower respiratory infections are two of the most common side effects reported by people taking Ocrevus in clinical trials. Upper respiratory infections were more common than lower respiratory infections .
Symptoms of a respiratory infection can include:
Most people who had an upper or lower respiratory infection while taking Ocrevus had mild cases. But, rarely, these infections can be severe.
What you can do
If you have an active infection before starting Ocrevus, the infection will need to be treated, or youll have to wait until it resolves before starting Ocrevus. This includes an upper or lower respiratory infection.
If you develop symptoms of an infection while taking Ocrevus, call your doctor. Theyll likely want to evaluate your symptoms further. If they diagnose an infection, they may prescribe antibiotics to treat it. They may also recommend treatments for any symptoms youre experiencing.
A simple but effective way to help prevent infection includes washing your hands. You should do this regularly, especially during Ocrevus treatment. For tips on how to properly wash your hands, check out this article.
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Questions About Receiving Ocrevus
The following are answers to some common questions about receiving Ocrevus.
- What if I miss a dose of Ocrevus? If you miss an appointment to receive your Ocrevus infusion, call your doctor right away to reschedule. After getting your missed dose, youll have to wait at least 5 months before getting your next infusion. Your doctor will adjust your dosing schedule if needed.
- Will I need to use Ocrevus long term? Yes, youll probably use Ocrevus long term. But talk with your doctor about how long you should use the drug.
- How long does Ocrevus take to work? Ocrevus starts working right away after you receive your first dose. But it may take several doses before your symptoms start to ease.
Talking with your doctor
You may have questions about Ocrevus and your treatment plan. Its important to discuss all your concerns with your doctor.
Here are a few tips that might help guide your discussion:
- Before your appointment, write down questions like:
- How will Ocrevus affect my body, mood, or lifestyle?
Bring someone with you to your appointment if doing so will help you feel more comfortable. If you dont understand something related to your condition or treatment, ask your doctor to explain it to you.
Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So dont be afraid to ask questions or offer feedback on your treatment.
Ways You Can Improve Hair Growth
There arent many proven treatments for hair loss but there are some things you can do to improve the health of your hair:
Make sure you are gentle with your hair. Avoid harsh treatments or colouring or tight hairstyles.
Take care of your scalp. Gently massage to increase blood flow and stimulate the scalp.
Keep your hair and scalp moistured condition your hair regularly.
If you believe your hair loss could be caused by stress, try mindfulness based stress reduction and meditation. This is a key part of the OMS Recovery Program.
Get your iron levels tested to check that you are not anaemic.
Wait and see most hair loss will stop in time and you will see regrowth.
Hair loss is not a symptom of MS, but could be related as a side effect of a medication, or due to the stress of an MS diagnosis. The majority of hair loss or thinning is temporary, and does not require treatment.
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Warnings Precautions And Adverse Reactions
Ocrevus can cause serious side effects, including infusion reactions such as itching, rash, hives, tiredness, shortness of breath, fever, flushing, nausea, headache, dizziness, fatigue, and tachycardia.1
It can also cause serious infections, including progressive multifocal leukoencephalopathy and hepatitis B virus reactivation. Finally, Ocrevus may increase the risk of malignancies including breast cancer.
Patients with an active HBV infection should not be treated with Ocrevus. All patients should receive any required live or live-attenuated vaccines at least 1 month before starting Ocrevus treatment and should not receive any live or live-attenuated vaccines while being treated with Ocrevus.
It is not known whether Ocrevus harms the fetus. Patients are advised to use effective contraception while being treated with Ocrevus and for 6 months after the last Ocrevus infusion. It is also not known whether Ocrevus passes into breast milk.
Ocrevus: What To Discuss With Your Doctor
Talk with your doctor or pharmacist to find out more information about Ocrevus. If you have questions about the drugs side effects, your pharmacist or healthcare professional can help answer them for you.
The more common side effects of Ocrevus tend to be mild ones. However, let your doctor know about any bothersome or severe side effects that you have with this drug.
In addition to discussing Ocrevus with your doctor, you may find the following articles helpful in learning more.
- Overview of Ocrevus. To read an overview of Ocrevus, see this article.
- Drug comparison. To learn how Ocrevus compares with Rituxan, read this article. To see a comparison with Lemtrada, check out this article.
- Details about multiple sclerosis . To learn more about MS, which Ocrevus is used to treat, see this article.
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What Every Ms Patient Should Know About Ocrevus And Its Use
With the recent approval of Ocrevus for both primary progressive and relapsing multiple sclerosis , interest in the medication is peaking. To help readers of Multiple Sclerosis News Today better understand this new medication and how it works, as well issues dealing with access, use, and potential side effects, here is a summary of the most relevant information now available about Ocrevus.
What Other Drugs Will Affect Ocrevus
Tell your doctor about all other medicines you have recently used to treat multiple sclerosis.
Other drugs may interact with ocrelizumab, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.
Ocrevus works in MS by targeting a specific protein, called CD20 that exists on the surface of immature and mature B-lymphocytes. B lymphocytes are a type of white blood cell which are thought to contribute to the development of MS in several different ways, including secreting antibodies during an MS attack that cause inflammation which damages the myelin coating around nerve cells in the brain and spinal cord. When Ocrevus binds to CD20, it causes B-cells to self-destruct or disintegrate, which reduces the number of MS relapse and the rate of disability progression. Continue reading
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Financial And Insurance Assistance
If you need financial support to pay for Ocrevus, or if you need help understanding your insurance coverage, help is available.
Genentech, the manufacturer of Ocrevus, offers a number of resources, including the Ocrevus Co-pay Program. For more information and to find out if youre eligible for support, call 844-OCREVUS or visit the program website.
B Cell Therapies: Rituximab Ocrelizumab
Rituximab and ocrelizumab, anti-CD20 B cell depleting monoclonal antibodies, have become critical agents in the management of MS, underlying the importance of B cells in the pathophysiology of MS. Rituximab is a chimeric monoclonal antibody targeted against CD20, while ocrelizumab is a humanized anti-CD20 agent. Although not FDA approved in demyelinating diseases, rituximab is widely used in the treatment of MS and Neuromyelitis Optica. Ocrelizumab was FDA approved in 2017 for RRMS and primary progressive multiple sclerosis based on two large phase III trials . Further anti-CD20 agents, currently in late stages of the development pipeline, include ofatumumab and ublituximab. The anti-CD20 therapies lead to elimination of CD20 expressing pre-B cells and mature lymphocytes via a variety of mechanisms, including antibody-dependent cellular cytotoxicity , antibody-dependent cellular phagocytosis, complement-dependent cytotoxicity , cell death via apoptosis and decreased antibody production .
Despite the success of anti-CD20 monoclonal antibodies in cancer treatment, there are also several cancers associated with the use of anti-B cell therapies. For example, ocrelizumab was associated with several cases of malignancy in clinical trials, including cases of renal cancer, melanoma, and breast cancers. Overall, 4 malignancies were reported in OPERA 1 trial in RRMS patients and 11 malignancies were reported in PPMS patients in the ORATORIO trial .
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Is Ocrevus Chemotherapy
No, Ocrevus is not chemotherapy. It belongs to a class of drugs called monoclonal antibodies.
Ocrevus works by decreasing the activity of your immune system and stopping it from attacking your body. Ocrevus targets specific cells called B cells. It decreases the number of B cells in your body, which can help relieve your MS symptoms.
How Ocrevus Is Given
Ocrevus is given as an intravenous infusion. This means a needle goes into a vein in your arm and delivers the medication slowly over time. Getting the medication slowly lowers your risk for having a reaction to the drug.
Your first dose of Ocrevus will be given over the course of 2.5 hours or longer. Then, youll get a second dose of medication 2 weeks after your first dose. This infusion will also be given over 2.5 hours or longer.
After your first two doses of medication, you only need to get one dose every 6 months. These doses will be given over the course of 3.5 hours or longer.
Your doctors office will work with you to make sure the infusion appointments fit your schedule. To help make sure you dont miss an appointment, try setting a reminder on your phone.
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Is Ocrevus Used For Ms
Ocrevus is prescribed to treat certain types of multiple sclerosis in adults.
MS is a condition that causes your immune system to attack the protective covering of your brain and spinal cord. This can cause swelling in your brain and spinal cord, which interrupts the communication between your brain and body.
Below are brief descriptions of each condition Ocrevus is used to treat.
- Clinically isolated syndrome . With CIS, you experience MS symptoms for at least 24 hours. Although CIS is usually the first sign of MS, it often occurs before an official MS diagnosis.
- Relapsing-remitting MS. Relapsing-remitting MS has repeated episodes of relapse and remission .
- Active secondary progressive MS. Active secondary progressive MS usually starts as relapsing-remitting MS. But over time, your MS symptoms continue to worsen.
- Primary progressive MS . If you have PPMS, you have continued worsening MS symptoms without ever having periods of remission.
What If I Miss A Dose
If you miss your appointment for an Ocrevus infusion, call your doctor as soon as possible to reschedule. Theyll adjust your dosing schedule as needed.
Talk with your doctor if you have questions about your dosing schedule. To help make sure you dont miss an appointment, try setting a reminder on your phone.
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Infections Such As Respiratory Or Skin Infections
Ocrevus weakens part of your immune system . As a result, it can increase your risk for infections. For example, you may have an increased risk for herpes infection .
In studies, infections were commonly reported in people using Ocrevus. Types of infections reported in people treated with Ocrevus include:
- blisters or spots
Most infections reported in studies, including herpes infections, were mild to moderate in severity.
But in rare cases, infections can be severe. Since Ocrevus has been on the market, serious cases of herpes infections have been reported in some people receiving this treatment. These include widespread skin or soft tissue infections, as well as herpes infections of the eyes or brain.
What might help
Here are a few tips that may help prevent you from getting an infection:
- Wash your hands or use hand sanitizer frequently, especially if youve been in a public place.
- Avoid crowds when possible.
- Stay away from people who are sick.
- Dont share facecloths, towels, lip balms, or lipsticks with others.
- Avoid kissing or sexual contact with someone who has an active herpes infection.
- Eat a healthy diet containing plenty of fruit and vegetables.
- Make sure youre up to date with immunizations before you start Ocrevus treatment.
See your doctor right away if you have an infection that starts to get worse or doesnt get better after about a week. You should also see your doctor right away if you have symptoms of a more serious herpes infection. These may include:
Convenience A Benefit Of Ocrevus
Another thing that makes Ocrevus appealing is the convenience factor. Existing DMTs are administered via pills, injections, or infusions, some requiring daily dosing, some weekly, some every two weeks, and some monthly. Ocrelizumab is given as an infusion twice a year.
Ocrevus has proved to be very convenient, says Ellen Lathi, MD, the director of the Elliot Lewis Center for Multiple Sclerosis in Wellesley, Massachusetts. Because you only need an infusion every six months, it allows patients to forget they have MS for 363 days of the year.
Risks and side effects of Ocrevus are comparable to those of other DMTs, though some research has suggested Ocrevus may raise the risk of breast cancer. As a precaution, women taking the medication are strongly advised by their physicians to stay up-to-date on mammograms.
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Why Are These Studies Important
Life expectancy for people living with MS has improved over time. However, on average, people with MS live 6-7 years less than the general population. Their most common cause of death is related to MS. However, depending on the study, cancer has been reported as the second or third most common cause of death in adults with MS. Does MS affect cancer outcomes? A better understanding of the impact of MS on cancer is needed to help patients and their healthcare providers make informed decisions about their treatment.
Breast Cancer Survival in Multiple Sclerosis
- Women with MS were more likely to die from any cause after a breast cancer diagnosis compared to women without MS.
- The reason for this difference is unknown. Possible reasons may include disability in women with MS. For example, women who have more disability due to MS may face barriers to treatment, may receive less aggressive treatment or may be more susceptible to complications from treatment or other factors that decreased their overall survival. Another possibility is that breast cancer or treatment for it worsened MS.
- Women with MS were no more likely to die from breast cancer compared to women without MS.
Colorectal Cancer Survival in Multiple Sclerosis
- People with MS were more likely to die from any cause after a colorectal cancer diagnosis compared to people without MS but only in the first 6-12 months after that diagnosis.