Ocrevus (ocrelizumab) / Roche, Biogen - LARVOL DELTA

Hypogammaglobulinemia and infection risks in multiple sclerosis patients receiving anti-CD20 monoclonal antibodies: Incidence, clinical implications, and longitudinal insights from a three-year Iranian cohort. (PubMed, Mult Scler Relat Disord) - "Our results revealed an 18.9 % incidence rate of SHG in MS patients treated with anti-rituximab and ocrelizumab, which was mainly asymptomatic and mild. We also demonstrated the lower baseline IgG levels and SID regimen as a risk factor to develop SHG. The incidence of SHG at year one was strongly associated with an increased risk of infection. Our findings underscore the IgG monitoring before and during anti-CD20 treatment, along with patient-tailored anti-CD20 regimens to mitigate the risk of SHG and infection."

Journal • CNS Disorders • Infectious Disease • Multiple Sclerosis

Inflammatory Bowel-Like Disease with Ileocolic and Perianal Involvement Induced by Ocrelizumab: A Case Report. (PubMed, Case Rep Gastroenterol) - "In the literature, there are some previously described cases reporting on enterocolitis induced by rituximab and ocrelizumab highlighting its potential severity. There are no clear recommendations on how to manage these patients. Clinicians must be aware of this entity and report on these unquestionably increasing conditions."

Journal • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Oncology

BI26 More than skin deep: a case of eosinophilic fasciitis in a patient with relapsing-remitting multiple sclerosis. (PubMed, Br J Dermatol) - "Her disease remains well controlled on methotrexate 15 mg once weekly. While the development of eosinophilic fasciitis in this case was presumed to be idiopathic, to our knowledge, this is the first case of eosinophilic fasciitis developing in the setting of long-term ocrelizumab use."

Journal • CNS Disorders • Dermatology • Eosinophilia • Hematological Disorders • Hematological Malignancies • Immunology • Mood Disorders • Multiple Sclerosis • Oncology • Pain • Rheumatology • Scleroderma • Systemic Sclerosis • CRP

Towards practical management of the Marburg variant of multiple sclerosis. (PubMed, Mult Scler Relat Disord) - "While no single regimen was uniformly effective, our three-group analysis suggests a stepwise strategy: steroids ± plasma exchange alone were often insufficient; adding a cytotoxic agent with dual B- and T-cell activity (cyclophosphamide or mitoxantrone) was associated with more frequent improvement; and the highest proportion of improvement occurred when dual-arm cytotoxic therapy was combined with a B-cell-directed/lymphocyte-depleting agent."

Journal • CNS Disorders • Multiple Sclerosis • Pediatrics

Effects of Ocrevus in Relapsing Multiple Sclerosis (clinicaltrials.gov) - P4 | N=60 | Active, not recruiting | Sponsor: Georgia State University | Trial completion date: Sep 2025 ➔ Dec 2025

Trial completion date • CNS Disorders • Multiple Sclerosis

Assessing Peripheral Blood Biomarkers and Predictive Patterns in Multiple Sclerosis Using Cytokines and Immune Gene Expression Profiles in Ocrelizumab-Treated Patients: Tracking Tumor Necrosis Factor. (PubMed, Int J Mol Sci) - "This result implies that PBMCs' TNF mRNA expression might be potentially considered as a prognostic biomarker of ocrelizumab effectiveness in MS patients. However, further studies comprising large cohorts and additional immunological parameters are warranted."

Biomarker • Journal • CNS Disorders • Multiple Sclerosis • Oncology • CD86 • IL6 • TNFA

Impact of ocrelizumab on quality of life, fatigue, and depression among multiple sclerosis patients. (PubMed, Acta Neurol Belg) - "Ocrelizumab treatment was associated with improved physical and mental HRQOL and reduced depression severity in MS patients."

HEOR • Journal • CNS Disorders • Depression • Fatigue • Mood Disorders • Multiple Sclerosis • Psychiatry

Selected aspects of epidemiology of multiple sclerosis in Poland: a multicenter pilot study. (PubMed, Neurol Neurochir Pol) - "This study highlights substantial progress in the diagnostic and therapeutic management of MS in Poland over the past 15 years. The widespread implementation of MRI and CSF analysis, alongside significantly improved access to DMTs, has contributed to notably better clinical outcomes. These improvements are reflected in reduced relapse rates, slower disability progression, and a decreased prevalence of secondary progressive MS."

Journal • CNS Disorders • Multiple Sclerosis

Late-onset severe neutropenia in patients with relapsing remitting multiple sclerosis treated with ocrelizumab: case report and literature review. (PubMed, Front Neurosci) - "Ocrelizumab was held, patient switched to ozanimod, but neutropenia recurred. A subsequent episode occurred 3 months later during confirmed rhinovirus infection, again resolving promptly. These cases highlight the unpredictable nature of recurrent LON with ocrelizumab and suggest the possibility of immune-mediated marrow suppression, potentially unmasked or worsened by infections, rather than direct drug toxicity, highlighting the need for clearer management guidelines."

Journal • CNS Disorders • Hematological Disorders • Immunology • Infectious Disease • Multiple Sclerosis • Neutropenia

Ocrelizumab transiently alters microbiota and modulates immune response depending on treatment outcome. (PubMed, iScience) - "Notably, lipopolysaccharide-binding protein and mannose-binding lectin decreased only in responders. These findings suggest that intestinal barrier damage contributes to immune responses linked to microbial translocation, MS pathogenesis, and treatment outcomes."

Journal • CNS Disorders • Immunology • Multiple Sclerosis • LBP

Combined intrathecal and intravenous exosome injection efficiency in a multiple sclerosis patient: a case report. (PubMed, Cell Mol Biol (Noisy-le-grand)) - "Here, we describe a 44-year-old female with a 21-year history of progressive MS unresponsive to interferon beta-1a and Ocrelizumab, who presented with widespread neurological deficits, including sensory disturbances, weakness, and urge incontinence...This case highlights significant symptomatic improvement in long-standing progressive MS following combined intrathecal and intravenous allogeneic UC-MSC exosome administration. The rapid clinical benefits and absence of new MRI activity suggest a potential modulatory role for exosome therapy in MS, although these encouraging findings from a single case with adjunctive therapy necessitate larger, controlled clinical trials to validate efficacy, safety, and optimal protocols, and to elucidate underlying mechanisms."

Clinical • Journal • Ataxia • CNS Disorders • Immunology • Movement Disorders • Multiple Sclerosis • Solid Tumor • Urinary Incontinence

Recent Advances in Interventions Targeting Remyelination and a Systematic Review of Remyelinating Effects of Approved Disease-Modifying Treatments for Multiple Sclerosis. (PubMed, Eur J Neurol) - "Future proof-of-concept clinical trials investigating remyelinating agents in MS should consider combining outcome measures into composite endpoints. Furthermore, research efforts should be dedicated to novel biomarkers to assess repair mechanisms in MS."

Journal • Review • CNS Disorders • Multiple Sclerosis • Solid Tumor

Early response in cytokine and miR-124a, -125b, -223 expression to anti-CD20 in Multiple Sclerosis and its animal model - a preliminary analysis. (PubMed, J Neuroimmunol) - "This is the first study to compare miR-124a-3p, miR-125b-5p, and miR-223-3p in both EAE and MS patients undergoing anti-CD20 therapy, suggesting subtype-specific molecular responses, identifying miR-223-3p as a potential biomarker of treatment response, and highlighting immune regulatory pathways as key mechanisms linking these miRNAs to disease progression and therapy outcomes."

Journal • Preclinical • CNS Disorders • Immunology • Inflammation • Multiple Sclerosis • CXCL10 • IL6 • miR-125b • MIR223

Injection to treat MS goes on the PBS (RACGP) - "Ocrelizumab (sold as Ocrevus) has been listed on the PBS to treat adult patients with relapsing-remitting multiple sclerosis (RRMS), the most common form of the disease....More than 30,000 Australians are expected to benefit from the PBS listing annually, with previous costs rising to more than $16,500 for each course of treatment."

Reimbursement • Multiple Sclerosis

BAFF is a marker of hypogammaglobulinemia, neuroaxonal damage and inflammation in multiple sclerosis patients on ocrelizumab. (PubMed, J Neuroinflammation) - "This study provides insight into unique biomarker profile in patients on ocrelizumab. Increased BAFF was associated with lower IgG and IgA levels, biomarkers of neuroaxonal damage and inflammation in MS patients without recent acute inflammatory activity on ocrelizumab."

Journal • CNS Disorders • Inflammation • Multiple Sclerosis • Solid Tumor • CCL20 • CDCP1 • CXCL13 • CXCL9 • GFAP • NEFL • SPP1 • TNFRSF10A

Comparative efficacy and safety of ocrelizumab in relapsing-remitting and primary progressive multiple sclerosis: A systematic review and meta-analysis. (PubMed, BMC Neurol) - "This study confirms OCR's significant efficacy in reducing relapse rates and its manageable safety profile in MS. However, its benefits on composite endpoints like NEDA and on halting disability progression remain uncertain and variable, highlighting a need for long-term studies to better define its role in mitigating disease progression."

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

Ocrelizumab Access by Socio-Economic Status (clinicaltrials.gov) - P=N/A | N=800 | Completed | Sponsor: Brigham and Women's Hospital | Not yet recruiting ➔ Completed | N=600 ➔ 800

Enrollment change • Real-world evidence • Trial completion • CNS Disorders • Multiple Sclerosis

Clinical Reasoning: A 30-Year-Old Female Patient With Multiple Sclerosis Presenting With Rapidly Progressive Cranial Neuropathies, Weakness, and Ataxia. (PubMed, Neurology) - "A 30-year-old woman with relapsing-remitting multiple sclerosis on ocrelizumab presented with subacute diplopia, dysarthria, spastic upper extremity diplegia, nausea, and vomiting...Extensive diagnostic testing was conducted, including evaluation of infectious, autoimmune, and paraneoplastic encephalitis causes. This case presentation discusses the causes and management of infectious rhombencephalitis, particularly in the setting of immunomodulatory therapy, and the nuance of infectious disease test result interpretation."

Journal • Ataxia • CNS Disorders • Immunology • Infectious Disease • Movement Disorders • Multiple Sclerosis • Oncology

Exploring the wearing-off phenomenon among anti-CD20 therapies in multiple sclerosis. (PubMed, Mult Scler Relat Disord) - "Wearing-off is frequently reported across anti-CD20 therapies, though its subjective nature and lack of biomarkers present challenges for targeted management strategies."

Journal • CNS Disorders • Cognitive Disorders • Fatigue • Mood Disorders • Multiple Sclerosis • Psychiatry

A Case of Novel Combination Therapy for Refractory Lupus Nephritis (KIDNEY WEEK 2025) - "She was treated with mycophenolate mofetil (MMF), hydroxychloroquine, and prednisone but required frequent steroids for persistent symptoms and serologic activity. She had an allergic reaction to rituximab and no response to 14 months of belimumab...She received six months of cyclophosphamide, with ocrelizumab later added due to poor response...Discussion In patients with LN who have suboptimal response to MMF/cyclophosphamide and prednisone, current literature recommends addition of voclosporin if high proteinuria or belimumab if prior flares...Belimumab therapy is known to have good serological and extrarenal outcomes (BLISS-LN). Our patient did not respond to either therapies individually with MMF and steroid; however, the novel combination of both achieved both clinical and serological remission for the first time in her 10 years of complicated SLE and LN history."

Clinical • Combination therapy • Acute Kidney Injury • Cardiovascular • Glomerulonephritis • Hypertension • Immunology • Inflammatory Arthritis • Lupus • Lupus Nephritis • Nephrology • Renal Disease • Systemic Lupus Erythematosus • Vasculitis

SurfSubQ: A Study to Investigate Effects of Ocrelizumab Treatment on Neurofilament Light Chain (NfL) Levels and Participant Satisfaction in Participants With Multiple Sclerosis (MS) (clinicaltrials.gov) - P=N/A | N=842 | Recruiting | Sponsor: Hoffmann-La Roche | N=349 ➔ 842 | Trial completion date: Nov 2026 ➔ Mar 2028 | Trial primary completion date: Nov 2026 ➔ Mar 2028

Enrollment change • Trial completion date • Trial primary completion date • CNS Disorders • Multiple Sclerosis

Stomatitis, Agranulocytosis, and Multiple Sclerosis in Pregnancy. (PubMed, Cureus) - "We report a case of a 32-year-old pregnant woman with a history of multiple sclerosis presenting with stomatitis, found to have agranulocytosis, in the outpatient setting. The patient had been initiated on ocrelizumab months prior and had an active influenza infection, both of which can be rarely associated with stomatitis and agranulocytosis."

Journal • Agranulocytosis • CNS Disorders • Dental Disorders • Granulocytopenia • Infectious Disease • Influenza • Multiple Sclerosis • Respiratory Diseases • Stomatitis

Predictive factors of response to anti-CGRP monoclonal antibodies in patients with multiple sclerosis (EHF-EHC 2025) - "Mainly used DMTs were ocrelizumab (25.5%), natalizumab (19.1%), and dimethyl fumarate (17.0%), while anti-CGRP treatments included anti-CGRP mAbs (95%) and atogepant (5%)...We confirm the safety of combined DMT and CGRP treatments in patients with both conditions. Timely and tailored therapy should be planned early in MS disease course to achieve the best outcomes."

Biomarker • Clinical • CNS Disorders • Migraine • Multiple Sclerosis

Fully-automated estimation of upper cervical cord cross-sectional area using pontomedullary junction referencing in multiple sclerosis. (PubMed, Front Neuroimaging) - "Inclusion criteria were treatment with natalizumab or ocrelizumab and absence of clinical/radiological disease activity over ≥2 years. CSA PMJ measures were negatively associated with disability (β = -0.08, p = 0.002), independent of age and sex. Automated measurement of spinal cord CSA at fixed distance from the PMJ is applicable in MS, performs better than vertebral-based CSA, and correlates with neurological disability."

Journal • CNS Disorders • Multiple Sclerosis

Persistent Classical and Atypical Memory B Cells Underlie Heterogeneous Vaccine Responses in Ocrelizumab-Treated Multiple Sclerosis. (PubMed, bioRxiv) - P=N/A | "Our findings identify persistent memory B cell subsets that escape OCR depletion as key immune correlates and mechanistic mediators of vaccine responsiveness in OCR-treated pwMS, highlighting potential targets to enhance vaccine efficacy in this population. All participating patients were enrolled in clinical trials NCT04843774 and NCT04682548 ."

Heterogeneity • Journal • CNS Disorders • Infectious Disease • Multiple Sclerosis • Novel Coronavirus Disease • Respiratory Diseases • CD27 • CD4 • CD8 • CXCR5 • ITGAX