Ocrevus (ocrelizumab) / Roche, Biogen - LARVOL DELTA

First-in-Human Craniospinal Low-Dose Radiation Therapy for Progressive Multiple Sclerosis: A Case Report (ASTRO 2026) - "Materials/ A male patient with ocrelizumab-refractory primary progressive MS (baseline EDSS 5.0) underwent the first-ever craniospinal LDRT treatment after providing informed consent for this experimental intervention... This first-in-human application of craniospinal LDRT for progressive MS demonstrates remarkable clinical efficacy with rapid improvement in disability and quality of life measures. The dramatic response, combined with established anti-inflammatory mechanisms of LDRT and emerging evidence in neurodegenerative diseases, provides compelling rationale for systematic investigation through IRB-approved clinical trials, the first of which is underway."

Case report • Clinical • First-in-human • P1 data • Breast Cancer • Hematological Malignancies • Oncology • Solid Tumor

Fistulizing Crohn's Disease With Rectovaginal and Perianal Involvement Following Ocrelizumab Therapy in Multiple Sclerosis (ACG 2026) - "She received a prednisone taper and surgical fistula repair...Upadacitinib is planned for ongoing fistulizing disease...Figure: Figure 1. (C, D) March 2026: complete resolution of inflammation with restoration of normal mucosal vascular pattern and haustral architecture (SES-CD 4)."

CNS Disorders • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Multiple Sclerosis

The Novel Use of Upadacitinib in Treatment of Refractory Ocrelizumab-Induced Colitis (OIC): A Case Report (ACG 2026) - "Suspected OIC was treated with IV methylprednisolone, leading to significant improvement; she was discharged on a prednisone taper and mesalamine 4.8 g daily...Symptoms remained well controlled on upadacitinib monotherapy until transition to natalizumab for dual MS and colitis management...Figure: Image 2. Histology from follow up colonoscopy with CD-20 immunostaining, demonstrating complete loss of CD20- positive B cells."

Case report • Clinical • CNS Disorders • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Multiple Sclerosis

Cytomegalovirus Esophagitis in a Patient on Ocrelizumab: A Case Report on Diagnostic and Management Challenges in Selective β Cell Depletion (ACG 2026) - "The patient completed valganciclovir 900 mg twice daily for three weeks with complete symptom resolution. Accessed March 25, 2026. https://www.pathologyoutlines.com/topic/esophagusCMVesophagitis.html"

Case report • Clinical • CNS Disorders • Cytomegalovirus Infection • Gastrointestinal Disorder • Infectious Disease • Inflammation • Multiple Sclerosis

Clinical and Epidemiological Characteristics of Multiple Sclerosis in a Peruvian Cohort: A Retrospective Study Across Three Lima Hospitals. (PubMed, Neurol Int) - "The most common initial treatment was interferon-beta (44.7%), while two patients (1.9%) initiated therapy with a highly effective disease-modifying drug (DMD), Ocrelizumab... This study describes clinical characteristics at onset and during follow-up that are largely similar to those reported in international series. However, we found no evidence of improved disease evolution, a finding potentially attributable to the heterogeneity of treatment and management strategies employed across the cohort."

Journal • Retrospective data • CNS Disorders • Movement Disorders • Multiple Sclerosis

Anti-CD20 monoclonal antibody therapies in relapsing multiple sclerosis: A systematic review and meta-analysis of randomised controlled trials. (PubMed, Mult Scler Relat Disord) - "Anti-CD20 mAbs confer consistent, clinically meaningful reductions in relapse rate and MRI disease activity. In the only direct head-to-head RCT, rituximab was non-inferior to ocrelizumab for MRI disease activity in newly diagnosed relapsing MS. Heterogeneity for MRI outcomes is strongly associated with trial design and warrants cautious interpretation; with few trials per stratum this attribution is associative rather than definitive. These agents represent a high-efficacy treatment class for relapsing MS."

Journal • Retrospective data • Review • CNS Disorders • Multiple Sclerosis

One target, two evidence streams: Rituximab versus ocrelizumab in relapsing multiple sclerosis: A design-stratified systematic review, meta-analysis, and concordance assessment. (PubMed, Mult Scler Relat Disord) - "Standardized rituximab achieved comparable MRI lesion suppression, but comparative clinical efficacy and serious-infection risk remain uncertain."

Journal • Retrospective data • Review • CNS Disorders • Infectious Disease • Multiple Sclerosis

Multimodal Single-Cell Profiling Reveals Distinct Systemic Immune Remodeling Following Ocrelizumab vs Ofatumumab Therapy (ACR Convergence 2026) - No abstract available

Immunology • Inflammation

Real-World Outcomes of Ocrelizumab and Ofatumumab Treatment in Pediatric-Onset Multiple Sclerosis. (PubMed, Paediatr Drugs) - "These results provide descriptive real-word data on the use of ocrelizumab and ofatumumab, especially when used as a first-line DMT in pediatric-onset multiple sclerosis. Although limited by a short follow-up period, our real-world findings provide safety and effectiveness data to inform DMT selection and shared decision making with families."

Journal • Real-world evidence • CNS Disorders • Infectious Disease • Multiple Sclerosis • Pediatrics

Ocrelizumab Discontinuation After Recurrent Serious Infections in Clinically Stable Primary Progressive Multiple Sclerosis: A Case Report. (PubMed, Cureus) - "This case underscores the need to reassess long-term therapy according to recent disease activity, cumulative treatment exposure, immunologic monitoring, infection history, functional status, comorbidities, care context, and patient goals. A single case cannot establish age-based or universal discontinuation thresholds; instead, it supports individualized shared decision-making regarding treatment continuation, interval extension, temporary interruption, or discontinuation."

Journal • CNS Disorders • Gastrointestinal Disorder • Infectious Disease • Inflammation • Multiple Sclerosis • Pneumonia • Respiratory Diseases

Babesiosis at ultra-low parasitemia presenting as secondary hemophagocytic lymphohistiocytosis in a patient on B cell-depleting therapy. (PubMed, ASM Case Rep) - "Ocrelizumab, an anti-CD20 B-lymphocyte monoclonal antibody used to treat multiple sclerosis, increases the risk of severe or relapsing infections with tick-borne pathogens...The patient improved following treatment with atovaquone and azithromycin, along with corticosteroids for HLH...Additionally, this case underscores the importance of maintaining a broad differential in patients on B cell-depleting agents who present with new pancytopenia and systemic inflammatory symptoms. Early utilization of microbial cell-free DNA next-generation sequencing tests may aid in timely diagnosis and treatment."

Journal • CNS Disorders • Hematological Disorders • Hemophagocytic lymphohistiocytosis • Immunology • Infectious Disease • Inflammation • Multiple Sclerosis • Rare Diseases

FENtrepid: A Study to Evaluate the Efficacy and Safety of Fenebrutinib Compared With Ocrelizumab in Adult Participants With Primary Progressive Multiple Sclerosis (clinicaltrials.gov) - P3 | N=985 | Active, not recruiting | Sponsor: Hoffmann-La Roche | Trial completion date: Feb 2027 ➔ Jul 2027

Trial completion date • CNS Disorders • Multiple Sclerosis

CHMP recommends EU approval of Roche’s Ocrevus for children and adolescents with relapsing multiple sclerosis (Roche Press Release) - "A final decision from the European Commission is expected in the near future....The CHMP's positive opinion is based on the Phase III OPERETTA 2 study, which showed that Ocrevus was non-inferior to fingolimod (the current standard treatment in paediatric MS) at controlling relapses, reducing the risk of relapses by 48% compared with fingolimod."

CHMP • Multiple Sclerosis

Ocrelizumab-related organizing pneumonia in multiple sclerosis: insights from a case series and literature review. (PubMed, J Neurol) - "Our findings support the emerging evidence of ocrelizumab-related OP and show substantial consistency with previously reported cases. Further studies are needed to clarify the potential role of CD20+ lymphocyte depletion in OP pathogenesis."

Journal • Retrospective data • Review • CNS Disorders • Cough • Infectious Disease • Interstitial Lung Disease • Multiple Sclerosis • Pneumonia • Pulmonary Disease • Respiratory Diseases • CD20

Errate: Nasal Mucociliary Clearance and Its Relationship With Disease Severity in Patients With Multiple Sclerosis. (PubMed, Med Sci Monit) - "In the published version of Figure 2, the bars representing the Ocrelizumab and Fingolimod treatment groups were inadvertently interchanged. 2026; 32:e952850. DOI: 10.12659/MSM.952850."

Journal • CNS Disorders • Multiple Sclerosis

A Study of Ocrelizumab in Children and Adolescents With Relapsing-Remitting Multiple Sclerosis (clinicaltrials.gov) - P2 | N=23 | Active, not recruiting | Sponsor: Hoffmann-La Roche | Trial completion date: Dec 2029 ➔ Apr 2032

Trial completion date • CNS Disorders • Multiple Sclerosis

Disease Course, Outcomes, and Complications in Pregnant and Breastfeeding Women with Multiple Sclerosis Treated with Rituximab or Ocrelizumab: A Narrative Review. (PubMed, J Res Pharm Pract) - "However, decision-making should be individualized, based on disease severity, timing of exposure, maternal benefit, and neonatal monitoring considerations. Prospective studies and expanded pregnancy registries are needed to better evaluate long-term maternal and infant outcomes."

Journal • Review • CNS Disorders • Infectious Disease • Multiple Sclerosis

Predictors of high- versus low-intensity first-line multiple sclerosis treatments. (PubMed, Mult Scler J Exp Transl Clin) - "The first DMT filled was classified as either high- (natalizumab, alemtuzumab, ocrelizumab, rituximab, ofatumumab, cladribine) or low-intensity (interferon, glatiramer acetate, teriflunomide, dimethyl fumarate, diroximel fumarate, fingolimod, ponesimod, siponimod, ozanimod)...The minority of MS patients initiated high-intensity treatment although this proportion increased over time, and later years were predictive of high-intensity treatment. Providers had a significant role in the approach selected."

Journal • CNS Disorders • Multiple Sclerosis

Multimodal discovery of a pathogenic B cell-dependent T cell state in multiple sclerosis. (PubMed, Brain) - "We combine longitudinal, high-dimensional multimodal immune profiling in patients initiating ocrelizumab with a novel machine learning pipeline to resolve treatment-induced shifts in continuous immune cell states, revealing treatment-associated modulation of shared biological processes that act across the boundaries of discretely partitioned cell types...Finally, we demonstrate that blockade of lymphocyte trafficking across the blood-brain barrier with the anti-integrin α4 therapy natalizumab leads to enrichment of this cell state in the circulation, demonstrating a mechanistically concordant effect across distinct high-efficacy MS therapies. Together, our findings support a B cell-dependent, pathogenic T cell state which links peripheral immune activation to CNS-compartmentalised smouldering neuroinflammation across disease stages. Direct therapeutic manipulation of this T cell state may represent a key opportunity for targeting chronic neuroinflammation and facilitate..."

Journal • CNS Disorders • Epstein-Barr Virus Infections • Inflammation • Multiple Sclerosis • ITGA4

Glioblastoma in a Patient with Multiple Sclerosis Treated with Ocrelizumab: A novel case report and literature review (SNO 2026) - No abstract available

Case report • Clinical • Review • Brain Cancer • CNS Disorders • Glioblastoma • Multiple Sclerosis • Solid Tumor

Ocrelizumab versus ofatumumab efficacy and safety after natalizumab discontinuation in multiple sclerosis: a retrospective real-world comparison. (PubMed, J Neurol) - No abstract available

Journal • Real-world evidence • Retrospective data • CNS Disorders • Multiple Sclerosis

Severe Nonhepatic Hyperammonemia Associated With Ureaplasma parvum and Mycoplasma hominis Infection in a Dually Immunosuppressed Woman Presenting As Suspected Peritoneal Carcinomatosis. (PubMed, Cureus) - "We report the case of a 63-year-old woman receiving dual biologic therapy, ocrelizumab for multiple sclerosis and secukinumab for psoriasis, who presented with a history of sterile pyuria and lower urinary tract symptoms...Following treatment with levofloxacin and doxycycline, sustained metabolic control allowed discontinuation of CRRT without further rebound hyperammonemia. The temporal pattern, while occurring alongside surgical drainage and peritoneal lavage, supports targeted treatment of the presumed underlying invasive infection as an important component of recovery. This case highlights the importance of considering fastidious urogenital organisms in immunosuppressed patients with unexplained nonhepatic hyperammonemia and persistently negative conventional cultures, particularly when ammonia levels remain dependent on extracorporeal clearance."

Journal • CNS Disorders • Critical care • Dermatology • Hepatology • Immunology • Infectious Disease • Liver Failure • Multiple Sclerosis • Oncology • Ovarian Cancer • Peritoneal Cancer • Psoriasis • Solid Tumor

Roche gets Phase 3 trial waiver for higher dose of multiple sclerosis drug (Business Standard) - "The 920 milligram (mg) version of Ocrelizumab was given this waiver by the neurology and psychiatry SEC at a meeting held on August 20...However, the waiver approval is subject to the condition that the firm shall conduct a Phase 4 clinical trial in the Indian population for the proposed indications."

Commercial • New P3 trial • New P4 trial • Immunology • Multiple Sclerosis

FENtrepid: A Study to Evaluate the Efficacy and Safety of Fenebrutinib Compared With Ocrelizumab in Adult Participants With Primary Progressive Multiple Sclerosis (clinicaltrials.gov) - P3 | N=985 | Active, not recruiting | Sponsor: Hoffmann-La Roche | Trial completion date: Jul 2027 ➔ Feb 2027

Trial completion date • CNS Disorders • Multiple Sclerosis

Ocrelizumab Discontinuation in Relapsing Multiple Sclerosis (clinicaltrials.gov) - P4 | N=123 | Active, not recruiting | Sponsor: National Institute of Allergy and Infectious Diseases (NIAID) | Recruiting ➔ Active, not recruiting | Trial completion date: Nov 2030 ➔ Feb 2032 | Trial primary completion date: May 2030 ➔ Aug 2031

Enrollment closed • Trial completion date • Trial primary completion date • CNS Disorders • Multiple Sclerosis • CSF2