Treatment:

Ocrevus® (ocrelizumab)

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The active ingredient of Ocrevus® is ocrelizumab. It is used for the treatment of patients with relapsing remitting MS to delay the progression of physical disability and to reduce the frequency of relapse. Ocrevus is also indicated for the treatment of patients with primary progressive multiple sclerosis (PPMS) to delay the progression of physical disability.

In MS, the immune system mistakenly attacks the protective layer (myelin) around the nerve cells. This causes inflammation and damage which stops the nervous system working properly. Ocrevus® works on the immune system to reduce the inflammation and attacks on the nervous system.

In clinical trials, Ocrevus® showed a reduction in relapses, less new lesions on magnetic resonance scan (MRI), less brain volume loss and lower levels of disability progression.

Ocrevus® is infused intravenously (IV) into a drip at a hospital infusion unit. You will be monitored by trained staff before, during and after your infusion.

When first starting Ocrevus®, the full 600mg dosage is split into 2 half doses of 300mg each, administered two weeks apart. Subsequent infusions of 600 mg of Ocrevus® will be given six months after the previous infusion.

Ocrevus® helps most people with MS, but may have side effects in some people. All medications have side effects. It is important to notify your health professional if you experience any side effects or are feeling unwell.

Side effects of Ocrevus® may include infusion related reactions. Tell your doctor or nurse immediately if you notice any of the following while receiving an infusion: swelling of the face, lips tongue or throat or other parts of the body, shortness of breath, rash, itching or hives, feeling sick (nausea), fever, cough, tiredness, headaches and dizziness, fast heartbeat.

Patients should tell their doctor immediately if they have any signs or symptoms of an infusion reaction or allergic reaction.

Clinical trials indicated that there may also be a slightly higher risk of some common viral infections such as the common cold.

Your neurologist will assist you to assess the risks and expected benefit of treatment with Ocrevus® prior to starting therapy and over the course of the treatment. Your health professional can provide comprehensive information on the use of Ocrevus®, including precautions and side effects.

Avoid treatment during pregnancy unless the potential benefit to the mother outweighs the potential risk to the fetus. Women of childbearing potential should use effective contraception during treatment and for 6 months after the last infusion.

If you are currently pregnant or trying to become pregnant, please discuss your individual circumstances and treatment options with your neurologist or healthcare team.

Women are advised to discontinue breastfeeding during therapy. Research in laboratory models has shown that Ocrevus® is excreted in breastmilk.

There is currently no information is available on the clinical use of Ocrevus® during breastfeeding. Because ocrelizumab is a large protein molecule, the amount in milk is likely to be very low and absorption is unlikely because it is probably destroyed in the infant’s gastrointestinal tract. Until more data becomes available, Ocrevus® should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant.

If you are currently breastfeeding, please discuss your individual circumstances and treatment options with your neurologist or healthcare team.

Ocrevus® has been approved by the Therapeutic Goods Administration (TGA) for the treatment of patients with relapsing remitting MS and also for the treatment of patients with primary progressive MS.

As Ocrevus® has specific patient management requirements, only neurologists are able to initiate treatment. Your neurologist will need to obtain a special authority to prescribe you with the medication. There are a number of criteria you are required to meet before your neurologist obtains authority to write this prescription.

For details of the criteria required to receive a prescription for Ocrevus® treatment through the PBS, please visit the official PBS website at: https://www.pbs.gov.au/medicine/item/11237K-11242Q

You will need to click on the red Authority Required (STREAMLINED) link.

If you are eligible for medications through the PBS, you will need to pay a contribution fee each time your prescription is dispensed. The Federal Government pays for the remaining cost. The amount of the contribution fee depends upon whether or not you have a pension or concession card. The amount of this fee is set each year by the Federal Government.

Further information about the PBS, your entitlements and details regarding the PBS safety net (which protects patients and their families requiring a large number of PBS items) is available through the Medicare Australia website at: www.medicare.gov.au

Ocrevus® is currently not available on the PBS for people with primary progressive MS. Ocrevus® will be available for people with primary progressive MS to purchase privately.

If you are not eligible for Ocrevus® through the PBS, for example if you are a visitor from overseas, your neurologist may write a private prescription. In this instance you will have to pay the full cost to the pharmacy that dispenses your medication. You will need to request a quote from your pharmacist for the price of any medication which is not subsidised by the PBS.

Ocrevus® (ocrelizumab)

Forms of MS used for:
Relapsing remitting MS and primary progressive MS
Administration route:
Intravenous infusion (into vein)
Dosage and frequency:
6-monthly; first treatment is split into two doses 14 days apart
Storage:
Stored in the pharmacy or clinic at 2-8°C
TGA approval date:
July 2017
Available on PBS:
Yes for relapsing remitting MS
Manufacturer:
Roche

For more information

Speak to your neurologist about what treatment best suits your individual circumstances.

MS Nurses can also provide information, training and ongoing support in managing your immunotherapy.

MS Australia does not recommend any specific disease-modifying treatment for people living with MS. Decisions about any treatments, taking into consideration the potential benefits and side effects for each individual’s circumstances, should be made in careful consultation with the person’s neurologist.

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Ocrevus®