Archive \ Volume.12 2021 Issue 3

The Role of Ocrelizumab in Multiple Sclerosis Treatment; Literature Review

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Multiple sclerosis is a common leading cause of disability worldwide. CD20-expressing B cells play a major role in multiple sclerosis pathogenesis. Hence, anti-CD20 monoclonal antibodies effectively deplete B cells mainly by complement-dependent cytotoxicity, antibody-dependent cell-mediated phagocytosis, and antibody-dependent cellular cytotoxicity. While the precise etiology remains unknown, it is now recognized that environmental factors, such as smoking, vitamin D deficiency, Ebstein-Barr virus (EBV) infection, adolescent obesity, and sedentary lifestyle in addition to certain genes that are involved in disease progression. This literature reviews the current data supporting the efficacy and safety of ocrelizumab in the multiple sclerosis population. Relevant articles to the topic were searched in the PubMed database. The MeSh words were used are multiple sclerosis, anti-CD20 monoclonal antibodies, and ocrelizumab. Anti-CD20 monoclonal antibodies, particularly ocrelizumab, have gained attention in this targeted population. Based on the currently available data, ocrelizumab seems effective in B cells depletion and provides favorable outcomes in multiple sclerosis patients. Nevertheless, although most reported adverse events are infusion-related, several reported serious infections were reported in response to ocrelizumab infusion.

How to cite:
Alenazy RH, Abualshamat MMS, Alqahs FSSD, Almutairi AFN, Alharbi MKM, Alkhuraimi BM, et al. The Role of Ocrelizumab in Multiple Sclerosis Treatment; Literature Review. Arch Pharm Pract. 2021;12(3):117-20.
Alenazy, R. H., Abualshamat, M. M. S., Alqahs, F. S. S. D., Almutairi, A. F. N., Alharbi, M. K. M., Alkhuraimi, B. M., Dhamiri, Y. A., Alshahrani, M. M. A., Alshahrani, K. M., Alghamdi, M. A., et al. (2021). The Role of Ocrelizumab in Multiple Sclerosis Treatment; Literature Review. Archives of Pharmacy Practice, 12(3), 117-120.

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1.        Nishanth K, Tariq E, Nzvere FP, Miqdad M, Cancarevic I. Role of Smoking in the Pathogenesis of Multiple Sclerosis: A Review Article. Cureus. 2020;12(8).

2.        Correale J, Gaitán MI, Ysrraelit MC, Fiol MP. Progressive multiple sclerosis: from pathogenic mechanisms to treatment. Brain. 2017;140(3):527-46. doi:10.1093/brain/aww258

3.        Howard J, Trevick S, Younger DS. Epidemiology of Multiple Sclerosis. Neurol Clin. 2016;34(4):919-39. doi:10.1016/j.ncl.2016.06.016

4.        Milo R. Therapies for multiple sclerosis targeting B cells. Croat Med J. 2019;60(2):87-98.

5.        Syed YY. Ocrelizumab: A Review in Multiple Sclerosis. CNS Drugs. 2018;32(9):883-90.

6.        Ancau M, Berthele A, Hemmer B. CD20 monoclonal antibodies for the treatment of multiple sclerosis: up-to-date. Expert Opin Biol Ther. 2019;19(8):829-43. doi:10.1080/14712598.2019.1611778

7.        Bigaut K, De Seze J, Collongues N. Ocrelizumab for the treatment of multiple sclerosis. Expert Rev Neurother. 2019;19(2):97-108. doi:10.1080/14737175.2019.1561284

8.        Menge T, Dubey D, Warnke C, Hartung HP, Stüve O. Ocrelizumab for the treatment of relapsing-remitting multiple sclerosis. Expert Rev Neurother. 2016;16(10):1131-9. doi:10.1080/14737175.2016.1227242

9.        Myhr KM, Torkildsen Ø, Lossius A, Bø L, Holmøy T. B cell depletion in the treatment of multiple sclerosis. Expert Opin Biol Ther. 2019;19(3):261-71. doi:10.1080/14712598.2019.1568407

10.      Sellebjerg F, Blinkenberg M, Sorensen PS. Anti-CD20 Monoclonal Antibodies for Relapsing and Progressive Multiple Sclerosis. CNS Drugs. 2020;34(3):269-80.

11.      Margoni M, Preziosa P, Filippi M, Rocca MA. Anti-CD20 therapies for multiple sclerosis: current status and future perspectives. J Neurol. 2021:1-19.

12.      Hartung HP, Berger T, Bermel RA, Brochet B, Carroll WM, Holmøy T, et al. Shorter infusion time of ocrelizumab: Results from the randomized, double-blind ENSEMBLE PLUS substudy in patients with relapsing-remitting multiple sclerosis. Mult Scler Relat Disord. 2020;46:102492.

13.      Bar-Or A, O’Brien SM, Sweeney ML, Fox EJ, Cohen JA. Clinical Perspectives on the Molecular and Pharmacological Attributes of Anti-CD20 Therapies for Multiple Sclerosis. CNS Drugs. 2021;35(9):985-97.

14.      Auguste P, Colquitt J, Connock M, Loveman E, Court R, Ciccarelli O. Ocrelizumab for Treating Patients with Primary Progressive Multiple Sclerosis: An Evidence Review Group Perspective of a NICE Single Technology Appraisal. Pharmacoecon. 2020;38(6):527-36.

15.      Gingele S, Jacobus TL, Konen FF, Hümmert MW, Sühs KW, Schwenkenbecher P, et al. Ocrelizumab depletes CD20+ T cells in multiple sclerosis patients. Cells. 2019;8(1):12. doi:10.3390/cells8010012

16.      Chaudhuri A. Ocrelizumab in multiple sclerosis: risks and benefits. Lancet. 2012;379(9822):1196-7. doi:10.1016/S0140-6736(12)60508-X

17.      Roach CA, Cross AH. Anti-CD20 B Cell Treatment for Relapsing Multiple Sclerosis. Front Neurol. 2021;11:595547. doi:10.3389/fneur.2020.595547

18.      Kappos L, Li D, Calabresi PA, O'Connor P, Bar-Or A, Barkhof F, et al. Ocrelizumab in relapsing-remitting multiple sclerosis: a phase 2, randomized, placebo-controlled, multicentre trial. Lancet. 2011;378(9805):1779-87. doi:10.1016/S0140-6736(11)61649-8

19.      Mulero P, Midaglia L, Montalban X. Ocrelizumab: a new milestone in multiple sclerosis therapy. Ther Adv Neurol Disord. 2018;11:1756286418773025.

20.      Fernandez‐Diaz E, Perez‐Vicente JA, Villaverde‐Gonzalez R, Berenguer‐Ruiz L, Candeliere Merlicco A, Martinez‐Navarro ML, et al. Real‐world experience of ocrelizumab in multiple sclerosis in a Spanish population. Ann Clin Transl Neurol. 2021;8(2):385-94.

21.      McCool R, Wilson K, Arber M, Fleetwood K, Toupin S, Thom H, et al. Systematic review and network meta-analysis comparing ocrelizumab with other treatments for relapsing multiple sclerosis. Mult Scler Relat Disord. 2019;29:55-61. doi:10.1016/j.msard.2018.12.040

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