How to manage side effects occurring due to Ocrelizumab?

Question

Hello doctor,

My sister, who is 34 years old, started Ocrevus (Ocrelizumab) for MS (multiple sclerosis) last month and has been experiencing unusual reactions. After each infusion, she gets intense muscle spasms, and her face feels numb for days. The nurse says this is normal, but these side effects seem different from those listed in the pamphlet. Her vision also becomes very blurry during treatment. Should we be concerned? Are these typical reactions to Ocrevus?

Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concerns. Please do not worry; I am here to help you.

I have not encountered any similar reports of side effects in my patients to date, and a literature review did not reveal any comparable cases published in medical journals. However, rare and specific side effects can occur in some patients. Additionally, the side effects may be related to the pre-medication administered before Ocrevus (Ocrelizumab) at each session. Typically, we start each session with infusions of medications such as Paracetamol, corticosteroids (a class of drugs that suppress the immune system), and an antihistamine (a class of drugs that reduces allergic reactions) to reduce the risk of potentially life-threatening reactions. However, these medications can also cause side effects.

Before making any decision regarding Ocrelizumab, it is important to consider whether the side effects are significant enough to warrant a change from this effective medication. There are limited alternatives to Ocrelizumab, such as Kesimpta (Ofatumumab) and Tysabri (Natalizumab), so any decision to switch should be made with caution. I recommend reporting her symptoms to her physician so they can evaluate the available options based on the severity of her disease and overall condition.

I hope this helps you.

Thank you.