OCRELIZUMAb

OCRELIZUMAb

Keejin Yoon, MS4

PRIOR TO TREATMENT

MONITORING

ADMINISTRATION

OCREVUS

DURING TREATMENT

OCREVUS ZUNOVO

VACCINATIONS

CONTRAINDICATIONS

ADVERSE EFFECTS

INDICATIONS

FDA

WARNINGS/PRECAUTIONS

PREGNANCY/BREASTFEEDING

REFERENCES

MECHANISM

Your patient is a 20 year-old female with a recent diagnosis of multiple sclerosis. She is interested in starting ocrelizumab for her disease modifying therapy. She is up to date on her vaccinations, and currently does not use contraception with her husband. She has no prior medical history. What labs should you order before initiating therapy?

Brain MindMap

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Brain MindMap

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Contextualizeyour topic

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Need more reasons to use dynamic content in the classroom? Well: 90% of the information we assimilate comes to us through vision and, moreover, we retain 42% more information when the content moves. What you read: interactivity and animation can make the most boring content become something fun. In Genially, we also create our designs to facilitate comprehension and learning, so that you level up with interactivity and make your content something that adds value and engages. If you want to provide additional information or develop the content in more detail, you can do so through your oral presentation. We recommend that you train your voice and rehearse: the best improvisation is always the most worked! Demonstrating enthusiasm, giving a smile, and maintaining visual contact with the rest of the people in the classroom can be your best allies when it comes to presenting content and creating motivating learning experiences.

With Genially templates you can include visual resources to engage the class from minute 1. You can also highlight key content to facilitate its assimilation and even embed external content that surprises and provides more context to the topic: videos, photos, audios... Whatever you want!

Use tables and infographics

Visual communication is a key tool. We find it easier to 'read' images than to read written text. That is why disciplines like Visual Thinking facilitate knowledge organization through the use of images, graphics, infographics, and simple drawings.

Did you know that Genially allows you to share your creation directly, without the need for downloads? Ready for students to view it on any device and learn from anywhere. We don't like to bore in our classes or work with flat content. It's time to bet on dynamic and interactive learning experiences that stimulate the thinking and creativity of each student.

Did you know that Genially allows you to share your creation directly, without the need for downloads? Ready for students to view it on any device and learn from anywhere. We don't like to bore in our classes or work with flat content. It's time to bet on dynamic and interactive learning experiences that stimulate the thinking and creativity of each student.

Here you can put a standout title

When carrying out a presentation, two objectives must be pursued: conveying information and avoiding yawns. To achieve this, it can be a good practice to create an outline and use words and concepts that help with content assimilation.

Link

• Plan the structure of your content.
• Give visual weight to the key points and most important ones.
• Define secondary messages with interactivity.
• Establish a flow throughout the content.
• Measure the results.

Here you can put a highlighted title

Need more reasons to use dynamic content in the classroom? Well: 90% of the information we assimilate comes to us through vision and, moreover, we retain 42% more information when the content moves. What you read: interactivity and animation can make the most boring content become something fun. In Genially, we also create our designs to facilitate comprehension and learning, so that you level up with interactivity and make your content something that adds value and engages. If you want to provide additional information or develop the content in more detail, you can do so through your oral presentation. We recommend that you train your voice and rehearse: the best improvisation is always the most worked! Demonstrating enthusiasm, giving a smile, and maintaining visual contact with the rest of the people in the classroom can be your best allies when it comes to presenting content and creating motivating learning experiences.

With Genially templates you can include visual resources to engage the class from minute 1. You can also highlight key content to facilitate its assimilation and even embed external content that surprises and provides more context to the topic: videos, photos, audios... Whatever you want!

Maps are a great ally, use them!

Interactive visual communication enhances learning outcomes on any topic and in any context. Before you begin creating, it's helpful to take a few minutes to consider what this map tells and teaches you.

Use tables and infographics

Visual communication is a key tool. We find it easier to 'read' images than to read written text. That is why disciplines like Visual Thinking facilitate knowledge organization through the use of images, graphics, infographics, and simple drawings.

Maps are a great ally, use them!

Interactive visual communication enhances learning outcomes on any topic and in any context. Before you begin creating, it's helpful to take a few minutes to consider what this map tells and teaches you.

Insert a fantastic video for your presentation

And use this space to describe it. Multimedia content is essential in a presentation, to leave everyone amazed. Also, this way you'll summarize the content and entertain the whole class.

• Disease-modifying therapy (DMT) to reduce MS relapses, delay progression of disability and limit new inflammation.
• Considered as "B-cell depleting therapy", where inhibiting memory B cell function is effective at inhibiting relapsing MS.
• Anti-CD20 monoclonal antibody targeting CD20 expressing B cells including memory B cells
• Mechanism not fully clear, thought to bind to CD20+ B-lymphocytes and resulting in antibody-dependent cellular cytolysis and complement mediated lysis

Maps are a great ally, use them!

Interactive visual communication enhances learning outcomes on any topic and in any context. Before you begin creating, it's helpful to take a few minutes to consider what this map tells and teaches you.

PRIOR TO FIRST DOSE

Check Hepatitis B status Quantitative serum immunoglobulins Liver function tests (ALT, ALP, tbili, ALP) Prior to beginning any DMT for MS, include:

• CBC w/ diff
• CMP
• TB screen
• JCV serology with titer
• VZV serology
• remote hepatitis serology panel
• baseline IgG/IgM levels
• serum HCG if warranted
• HIV status if warranted

Did you know that Genially allows you to share your creation directly, without the need for downloads? Ready for students to view it on any device and learn from anywhere. We don't like to bore in our classes or work with flat content. It's time to bet on dynamic and interactive learning experiences that stimulate the thinking and creativity of each student.

Here you can put a highlighted title

Need more reasons to use dynamic content in the classroom? Well: 90% of the information we assimilate comes to us through vision and, moreover, we retain 42% more information when the content moves. What you read: interactivity and animation can make the most boring content become something fun. In Genially, we also create our designs to facilitate comprehension and learning, so that you level up with interactivity and make your content something that adds value and engages. If you want to provide additional information or develop the content in more detail, you can do so through your oral presentation. We recommend that you train your voice and rehearse: the best improvisation is always the most worked! Demonstrating enthusiasm, giving a smile, and maintaining visual contact with the rest of the people in the classroom can be your best allies when it comes to presenting content and creating motivating learning experiences.

With Genially templates you can include visual resources to engage the class from minute 1. You can also highlight key content to facilitate its assimilation and even embed external content that surprises and provides more context to the topic: videos, photos, audios... Whatever you want!

Use tables and infographics

Visual communication is a key tool. We find it easier to 'read' images than to read written text. That is why disciplines like Visual Thinking facilitate knowledge organization through the use of images, graphics, infographics, and simple drawings.

fda-approved indications

• Relapsing forms of multiple sclerosis including clinically isolated syndrome, relapsing-remitting disease, active secondary progressive disease in adults
• Primary progressive MS in adults

During Treatment

• Ensure no active infections with each dose
• Routine labs include CBC, CD19 count, IgG/IgM levels, serum HCG (if woman of childbearing age) 2 weeks prior to each dose

references

• https://www.ocrevus-hcp.com/dosing/ocrevus-administration.html
• https://www.ocrevus-hcp.com/dosing/ocrevus-zunovo-administration.html
• https://pmc.ncbi.nlm.nih.gov/articles/PMC5474520/
• https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2015.00565/full
• https://my.clevelandclinic.org/departments/neurological/depts/multiple-sclerosis/ms-approaches/safety-monitoring-multiple-sclerosis-patients-disease-modifying-therapies

Maps are a great ally, use them!

Interactive visual communication enhances learning outcomes on any topic and in any context. Before you begin creating, it's helpful to take a few minutes to consider what this map tells and teaches you.

Pregnancy and breastfeeding

• Contraindicated in pregnancy, women of childbearing potential should use effective contraception while receiving ocrelizumab and for 6 months after last dose.
• No data regarding presence of ocrelizumab or hyaluronidase in human milk or effect on breast fed infants.
• Ocrelizumab excreted in milk in animal studies, and human IgG is excreted in milk; no data regarding effects of absorbed ocrelizumab in breastfed infants

Insert a fantastic video for your presentation

And use this space to describe it. Multimedia content is essential in a presentation, to leave everyone amazed. Also, this way you'll summarize the content and entertain the whole class.

Here you can put a standout title

When carrying out a presentation, two objectives must be pursued: conveying information and avoiding yawns. To achieve this, it can be a good practice to create an outline and use words and concepts that help with content assimilation.

Link

• Plan the structure of your content.
• Give visual weight to the key points and most important ones.
• Define secondary messages with interactivity.
• Establish a flow throughout the content.
• Measure the results.

Here you can put a highlighted title

Need more reasons to use dynamic content in the classroom? Well: 90% of the information we assimilate comes to us through vision and, moreover, we retain 42% more information when the content moves. What you read: interactivity and animation can make the most boring content become something fun. In Genially, we also create our designs to facilitate comprehension and learning, so that you level up with interactivity and make your content something that adds value and engages. If you want to provide additional information or develop the content in more detail, you can do so through your oral presentation. We recommend that you train your voice and rehearse: the best improvisation is always the most worked! Demonstrating enthusiasm, giving a smile, and maintaining visual contact with the rest of the people in the classroom can be your best allies when it comes to presenting content and creating motivating learning experiences.

With Genially templates you can include visual resources to engage the class from minute 1. You can also highlight key content to facilitate its assimilation and even embed external content that surprises and provides more context to the topic: videos, photos, audios... Whatever you want!

Vaccinations

Complete necessary vaccinations prior to intiation of therapy Live/live-attenuated - complete 4 weeks prior Non-live - complete 2 weeks prior

Here you can put a standout title

When carrying out a presentation, two objectives must be pursued: conveying information and avoiding yawns. To achieve this, it can be a good practice to create an outline and use words and concepts that help with content assimilation.

Link

• Plan the structure of your content.
• Give visual weight to the key points and most important ones.
• Define secondary messages with interactivity.
• Establish a flow throughout the content.
• Measure the results.

Here you can put a standout title

When carrying out a presentation, two objectives must be pursued: conveying information and avoiding yawns. To achieve this, it can be a good practice to create an outline and use words and concepts that help with content assimilation.

Link

• Plan the structure of your content.
• Give visual weight to the key points and most important ones.
• Define secondary messages with interactivity.
• Establish a flow throughout the content.
• Measure the results.

route of administration, dosing, frequency

• HCP-administered subcutaneous injection of
• Formulated as 920 mg ocrelizumab + 23000 units hyaluronidase as active excipient
• Scheduled injections every 6 months
• Similar to Ocrevus, pre-medicate with oral 20 mg of dexamethasone and antihistamine
• Post-dose observation for first dose for 60 minutes, 15 minutes for subsequent doses
• Rule out any active infection prior to administration

Use tables and infographics

Visual communication is a key tool. We find it easier to 'read' images than to read written text. That is why disciplines like Visual Thinking facilitate knowledge organization through the use of images, graphics, infographics, and simple drawings.

ROUTE OF ADMINISTRATION, dOSING, FREQUENCY

• IV infusions
• 300 mg once on day 1, followed by 300 mg day 15; subsequent doses of 600 mg are administered once every 6 months (beginning 6 months after the first 300 mg dose)
• Pre-medicate with 100 mg methylprednisone and antihistamine (diphenhydramine) 30-60 minutes prior to each infusion to reduce frequency and severity of infusion reactions
• Post-dose monitiroing for 60 minutes for infusion reactions
• Rule out any active infection prior to each infusion

Role of memory B cells in multiple sclerosis pathophysiology. B cells from the periphery migrate across the blood-brain barrier to the CNS, consisting of memory B cells/plasmablasts. These naive B cells then populate meningeal germinal center-like structures, and produce CNS- restricted memory B cells, causing further clonal expansion and affinity maturation to CNS specific antigens, resulting in inflammation and immune-mediated demyelination characteristic of MS.

Did you know that Genially allows you to share your creation directly, without the need for downloads? Ready for students to view it on any device and learn from anywhere. We don't like to bore in our classes or work with flat content. It's time to bet on dynamic and interactive learning experiences that stimulate the thinking and creativity of each student.

Insert a fantastic video for your presentation

And use this space to describe it. Multimedia content is essential in a presentation, to leave everyone amazed. Also, this way you'll summarize the content and entertain the whole class.

Insert a fantastic video for your presentation

And use this space to describe it. Multimedia content is essential in a presentation, to leave everyone amazed. Also, this way you'll summarize the content and entertain the whole class.

Contraindications

• Active Hepatitis B infection
• Past history of life-threatening or hypersensitivity reactions to ocrelizumab or other components.

wARNINGS AND PRECAUTIONS

• Infusion reactions (34%-40%, highest incidence within first infusion) including pruritis, rash, urticaria, erythema, bronchospasm, throat irritation, oropharyngeal pain, dyspnea, pharyngeal/laryngeal edema, flushing, hypotension, pyrexia, fatigue, headache, dizziness, nausea, tachycardia, and anaphylaxis
• Injection reactions (ocrevus zunovo): local (erythema, pain, swelling, pruritis) and systemic (nausea, headache)
• Increased risk of URIs, LRIs, skin infections, herpes-related infections, hepatitis B virus reactivation
• RARE: progressive multifocal leukoenceaphlopathy secondary to JC virus
• Decreased immunoglobulin levels
• Increased risk of malignancy, including breast cancer
• Immune-mediated colitis