Name of the Procedure:

Injection, ocrelizumab, 1 mg
Common Names: Ocrevus Injection
Technical/Medical Terms: Monoclonal Antibody Therapy for Multiple Sclerosis

Summary

Ocrelizumab (brand name Ocrevus) is a medication administered via injection to treat certain types of multiple sclerosis (MS). It helps reduce the frequency of flare-ups and may slow the progression of physical disability in patients with MS.

Purpose

This injection is used to manage multiple sclerosis, specifically relapsing-remitting MS (RRMS) and primary progressive MS (PPMS). The treatment aims to reduce the activity of the immune system to prevent it from attacking the nervous system.

Indications

• Relapsing-remitting multiple sclerosis (RRMS)
• Primary progressive multiple sclerosis (PPMS)
• Appropriate for adults with confirmed MS diagnosis and matching symptoms
• Prior treatments have not been effective or are not well-tolerated

Preparation

• Pre-injection medical evaluation and history review
• Blood tests to check for infections and overall health status
• No specific fasting instructions, but stay hydrated
• May need to stop certain medications as advised by the doctor

Procedure Description

1. The patient is seated or lying comfortably.
2. An intravenous (IV) line is inserted into a vein, typically in the arm.
3. Pre-medications (like steroids, antihistamines) are administered to reduce infusion reactions.
4. Ocrelizumab is diluted and slowly administered via the IV line.
5. The infusion process is monitored by healthcare professionals to manage any adverse reactions.
6. The procedure involves specialized equipment such as an infusion pump.

Duration

The initial infusion may take approximately 2.5 to 4 hours. Subsequent infusions usually take about 2 to 3.5 hours.

Setting

The procedure is performed in a clinical setting such as a hospital infusion center or an outpatient facility.

Personnel

• Infusion Nurses
• Neurologist
• Pharmacist

Risks and Complications

• Common Risks: Infusion reactions (itching, rash, hives, fever)
• Rare Risks: Serious infections, potential for malignancy
• Possible Complications: Increased risk of respiratory infections and, rarely, progressive multifocal leukoencephalopathy (PML), a serious brain infection

Benefits

• Significant reduction in the frequency of MS relapses
• Potential slowing down of disease progression
• Improvement in daily functioning and quality of life
• Benefits can be observed within a few months of treatment

Recovery

• Post-infusion monitoring for a short period to ensure no adverse reactions
• Light activity for the first 24-48 hours
• Patients can typically resume normal activities within a day or two
• Scheduled follow-up appointments to monitor progress and health

Alternatives

• Other Disease-Modifying Therapies (DMTs) like interferon beta, glatiramer acetate, or other monoclonal antibodies (e.g., natalizumab)
• Pros: Some alternatives may have fewer or different side effects
• Cons: Alternatives may be less effective or more frequent in administration

Patient Experience

• During: Potential mild discomfort at IV site, feeling of cold as the infusion starts, possible mild side effects like headache or nausea
• After: Generally mild fatigue, potential mild flu-like symptoms which usually resolve within a day
• Pain Management: Pre-medications help manage potential side effects; over-the-counter pain relievers can be used post-infusion if necessary.