For Patients and Caregivers

What’s on this page:

Dosing schedule
Infusion rate tables
Infusion reactions
Quick Links to Resources
Dosing and Administration Guide

Dosing Schedule1

Shorter 2-hour infusion option after first dose

TREATMENT INITIATION

Timeline of initial and subsequent OCREVUS® (ocrelizumab) doses

OCREVUS shorter infusion for subsequent doses67

  • Three treatments in the first year: first 600-mg dose administered as two 300-mg IV infusions over approximately 2.5 hours, separated by 2 weeks; subsequent doses administered as a single 600-mg IV infusion every 6 months.1
  • Infusion time may take longer if the infusion is interrupted or slowed. No change in premedication, dose, formulation, or posttreatment monitoring between infusion timing options.1
  • Per the ENSEMBLE study protocol, serious IRs included those that were fatal or life threatening, required or prolonged hospitalization, resulted in persistent or significant disability, or were deemed to be medically significant by the trial investigator.68

ONE 600-MG INFUSION EVERY 6 MONTHS BEYOND INITIAL TREATMENT1

Important pre-infusion screening and medication1

Information about pretreatment evaluation and preparations needed before every infusion

For information about COVID-19 vaccine use and OCREVUS, download the COVID-19 Fact Card.

Delayed or missed doses1

  • If a planned infusion of OCREVUS is missed, administer OCREVUS as soon as possible; do not wait until the next scheduled dose
  • Reset the dose schedule to administer the sequential dose 6 months after the missed dose is administered. Doses of OCREVUS must be separated by at least 5 months
With the OCREVUS dosing schedule, patients only need 2 infusions every 12 months1

Infusing OCREVUS

PREMEDICATION AND OBSERVATION

Recommended dose, infusion rate, and infusion duration for RMS and PPMS1

Recommended dose, infusion rate, and infusion duration for administering 3.5- to 4-hour infusion and 2-hour shorter infusion options.

†Administer the first subsequent dose 6 months after infusion 1 of the initial dose.

Solutions of OCREVUS for intravenous infusion are prepared by dilution of the drug product into an infusion bag containing 0.9% sodium chloride injection, to a final drug concentration of approximately 1.2 mg/mL.

The OCREVUS Dosing and Administration Guide

For quick reference, download the OCREVUS Dosing Guide for instruction on how to administer OCREVUS.

Download the Guide

Shorter 2-Hour Infusion

2-hour infusion is available for patients who have not experienced serious IRs with any previous OCREVUS infusion1

Per the ENSEMBLE protocol, serious IRs included those that were fatal or life threatening, required or prolonged hospitalization, resulted in persistent or significant disability, or were deemed to be medically significant by the trial investigator.68

NO LIFE-THREATENING, FATAL, OR SERIOUS IRs OCCURRED WITH OCREVUS IN THE ENSEMBLE PLUS STUDY1,67

  • Overall, in all randomized doses, 27.1% of the patients in the 2-hour infusion group and 25.0% of the patients in the 3.5-hour infusion group reported mild or moderate infusion reactions; two infusion reactions were severe in intensity, with 1 severe infusion reaction (0.3%) reported in 1 patient in each group in this substudy.

ENSEMBLE PLUS evaluated the safety of OCREVUS 2-hour infusion1

A prospective, multicenter, randomized, double-blind, controlled, parallel-arm substudy of 580 patients with early RRMS. 81% (469/579) of treated patients received a single randomized infusion of OCREVUS for the primary analysis.

3.5- to 4-hour infusion of OCREVUS: 99.7% of infusions did not result in serious IRs in the OPERA and ORATORIO studies (controlled period)1,69

  • IRs were highest with the first infusion. Of the IRs that occurred, most were mild to moderate in severity
  • 0.3% of OCREVUS-treated MS patients experienced IRs that were serious, some requiring hospitalization

Managing infusion reactions in your patients1

For mild to moderate infusion reactions, reduce the infusion rate to half the rate of when the reacton began and maintain the reduced rate for at least 30 minutes. If tolerated, increase the infusion rate according to the initial infusion schedule. For severe reactions, interrupt the infusion immediately and provide supportive treatment. Only restart the infusion after all symtpoms have resolved, at half the infusion rate of when the reaction began. For life-threatening or disabling reactions, immediately stop infusion and provide appropriate supportive treatment. Permanently discontinue OCREVUS in these patients.

The OCREVUS Dosing and Administration Guide

For quick reference, download the OCREVUS Dosing Guide for instruction on how to administer OCREVUS.

Download the Guide

DMT=disease-modifying therapy; PPMS=primary progressive multiple sclerosis; RMS=relapsing multiple sclerosis.

Quick links to resources

Dosing & Administration Guide
COVID-19 Fact Card

Important Safety Information & Indications

Indications

OCREVUS is indicated for the treatment of:

  • Relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults
  • Primary progressive MS, in adults.
Contraindications

OCREVUS is contraindicated in patients with active hepatitis B virus infection and in patients with a history of life-threatening infusion reaction to OCREVUS.

Warnings and Precautions
Infusion Reactions

OCREVUS can cause infusion reactions, which can include pruritus, rash, urticaria, erythema, bronchospasm, throat irritation, oropharyngeal pain, dyspnea, pharyngeal or laryngeal edema, flushing, hypotension, pyrexia, fatigue, headache, dizziness, nausea, tachycardia, and anaphylaxis. In multiple sclerosis (MS) clinical trials, the incidence of infusion reactions in OCREVUS-treated patients [who received methylprednisolone (or an equivalent steroid) and possibly other pre-medication to reduce the risk of infusion reactions prior to each infusion] was 34-40%, with the highest incidence with the first infusion. There were no fatal infusion reactions, but 0.3% of OCREVUS-treated MS patients experienced infusion reactions that were serious, some requiring hospitalization.

Observe patients treated with OCREVUS for infusion reactions during the infusion and for at least one hour after completion of the infusion. Inform patients that infusion reactions can occur up to 24 hours after the infusion. Administer pre-medication (e.g., methylprednisolone or an equivalent corticosteroid, and an antihistamine) to reduce the frequency and severity of infusion reactions. The addition of an antipyretic (e.g., acetaminophen) may also be considered. For life-threatening infusion reactions, immediately and permanently stop OCREVUS and administer appropriate supportive treatment. For less severe infusion reactions, management may involve temporarily stopping the infusion, reducing the infusion rate, and/or administering symptomatic treatment.

Infections

Serious, including life-threatening or fatal, bacterial, viral, parasitic and fungal infections have been reported in patients receiving OCREVUS. An increased risk of infections (including serious and fatal bacterial, fungal, and new or reactivated viral infections) has been observed in patients during and following completion of treatment with anti-CD20 B-cell depleting therapies.

A higher proportion of OCREVUS-treated patients experienced infections compared to patients taking REBIF or placebo. In RMS trials, 58% of OCREVUS-treated patients experienced one or more infections compared to 52% of REBIF-treated patients. In the PPMS trial, 70% of OCREVUS-treated patients experienced one or more infections compared to 68% of patients on placebo. OCREVUS increased the risk for upper respiratory tract infections, lower respiratory tract infections, skin infections, and herpes-related infections. OCREVUS was not associated with an increased risk of serious infections in MS patients in controlled trials. Delay OCREVUS administration in patients with an active infection until the infection is resolved.

Respiratory Tract Infections

A higher proportion of OCREVUS-treated patients experienced respiratory tract infections compared to patients taking REBIF or placebo. In RMS trials, 40% of OCREVUS-treated patients experienced upper respiratory tract infections compared to 33% of REBIF-treated patients, and 8% of OCREVUS-treated patients experienced lower respiratory tract infections compared to 5% of REBIF-treated patients. In the PPMS trial, 49% of OCREVUS-treated patients experienced upper respiratory tract infections compared to 43% of patients on placebo and 10% of OCREVUS-treated patients experienced lower respiratory tract infections compared to 9% of patients on placebo. The infections were predominantly mild to moderate and consisted mostly of upper respiratory tract infections and bronchitis.

Herpes

In active-controlled (RMS) clinical trials, herpes infections were reported more frequently in OCREVUS-treated patients than in REBIF-treated patients, including herpes zoster (2.1% vs. 1.0%), herpes simplex (0.7% vs. 0.1%), oral herpes (3.0% vs. 2.2%), genital herpes (0.1% vs. 0%), and herpes virus infection (0.1% vs. 0%). Infections were predominantly mild to moderate in severity. In the placebo-controlled (PPMS) clinical trial, oral herpes was reported more frequently in the OCREVUS-treated patients than in the patients on placebo (2.7% vs 0.8%).

Serious cases of infections caused by herpes simplex virus and varicella zoster virus, including central nervous system infections (encephalitis and meningitis), intraocular infections, and disseminated skin and soft tissue infections, have been reported in the postmarketing setting in multiple sclerosis patients receiving OCREVUS. Serious herpes virus infections may occur at any time during treatment with OCREVUS. Some cases were life-threatening.

If serious herpes infections occur, OCREVUS should be discontinued or withheld until the infection has resolved, and appropriate treatment should be administered.

Hepatitis B Virus (HBV) Reactivation

Hepatitis B reactivation has been reported in MS patients treated with OCREVUS in the postmarketing setting. Fulminant hepatitis, hepatic failure, and death caused by HBV reactivation have occurred in patients treated with anti-CD20 antibodies. Perform HBV screening in all patients before initiation of treatment with OCREVUS. Do not administer OCREVUS to patients with active HBV confirmed by positive results for HBsAg and anti-HB tests. For patients who are negative for surface antigen [HBsAg] and positive for HB core antibody [HBcAb+] or are carriers of HBV [HBsAg+], consult liver disease experts before starting and during treatment.

Possible Increased Risk of Immunosuppressant Effects with Other Immunosuppressants

When initiating OCREVUS after an immunosuppressive therapy or initiating an immunosuppressive therapy after OCREVUS, consider the potential for increased immunosuppressive effect. OCREVUS has not been studied in combination with other MS therapies.

Vaccinations

Administer all immunizations according to immunization guidelines at least 4 weeks prior to initiation of OCREVUS for live or live-attenuated vaccines and, whenever possible, at least 2 weeks prior to initiation of OCREVUS for non-live vaccines. OCREVUS may interfere with the effectiveness of non-live vaccines. The safety of immunization with live or live-attenuated vaccines following OCREVUS therapy has not been studied, and vaccination with live-attenuated or live vaccines is not recommended during treatment and until B-cell repletion.

Vaccination of Infants Born to Mothers Treated with OCREVUS During Pregnancy

In infants of mothers exposed to OCREVUS during pregnancy, do not administer live or live-attenuated vaccines before confirming the recovery of B-cell counts as measured by CD19+ B-cells. Depletion of B-cells in these infants may increase the risks from live or live-attenuated vaccines.

You may administer non-live vaccines, as indicated, prior to recovery from B-cell depletion, but should consider assessing vaccine immune responses, including consultation with a qualified specialist, to assess whether a protective immune response was mounted.

Progressive Multifocal Leukoencephalopathy (PML)

Cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients with MS treated with OCREVUS in the postmarketing setting. PML is an opportunistic viral infection of the brain caused by the JC virus (JCV) that typically only occurs in patients who are immunocompromised, and that usually leads to death or severe disability. PML has occurred in OCREVUS-treated patients who had not been treated previously with natalizumab, (which has a known association with PML), were not taking any immunosuppressive or immunomodulatory medications, associated with risk of PML prior to or concomitantly with OCREVUS, and did not have any known ongoing systemic medical conditions resulting in compromised immune system function.

JCV infection resulting in PML has also been observed in patients treated with other anti-CD20 antibodies and other MS therapies.

At the first sign or symptom suggestive of PML, withhold OCREVUS and perform an appropriate diagnostic evaluation. Typical symptoms associated with PML are diverse, progress over days to weeks, and include progressive weakness on one side of the body or clumsiness of limbs, disturbance of vision, and changes in thinking, memory, and orientation leading to confusion and personality changes.

Magnetic resonance imaging (MRI) findings may be apparent before clinical signs or symptoms of PML. Monitoring with MRI for signs consistent with PML may be useful, and any suspicious findings should lead to further investigation to allow for an early diagnosis of PML, if present.

If PML is confirmed, treatment with OCREVUS should be discontinued.

Reduction in Immunoglobulins

As expected with any B-cell depleting therapy, decreased immunoglobulin levels are observed with OCREVUS treatment. The pooled data of OCREVUS clinical studies (RMS and PPMS) and their open-label extensions (up to approximately 7 years of exposure) have shown an association between decreased levels of immunoglobulin G (IgG<LLN) and increased rates of serious infections. Monitor the levels of quantitative serum immunoglobulins during OCREVUS treatment and after discontinuation of treatment, until B-cell repletion, and especially in the setting of recurrent serious infections. Consider discontinuing OCREVUS therapy in patients with serious opportunistic or recurrent serious infections, and if prolonged hypogammaglobulinemia requires treatment with intravenous immunoglobulins.

Malignancies

An increased risk of malignancy with OCREVUS may exist. In controlled trials, malignancies, including breast cancer, occurred more frequently in OCREVUS-treated patients. Breast cancer occurred in 6 of 781 females treated with OCREVUS and none of 668 females treated with REBIF or placebo. Patients should follow standard breast cancer screening guidelines.

Immune-Mediated Colitis

Immune-mediated colitis, which can present as a severe and acute-onset form of colitis, has been reported in patients receiving OCREVUS in the postmarketing setting. Some cases of colitis were serious, requiring hospitalization, with a few patients requiring surgical intervention. Systemic corticosteroids were required in many of these patients. The time from treatment initiation to onset of symptoms in these cases ranged from a few weeks to years. Monitor patients for immune-mediated colitis during OCREVUS treatment, and evaluate promptly if signs and symptoms that may indicate immune-mediated colitis, such as new or persistent diarrhea or other gastrointestinal signs and symptoms, occur.

Use in Specific Populations
Pregnancy

There are no adequate data on the developmental risk associated with use of OCREVUS in pregnant women. There are no data on B-cell levels in human neonates following maternal exposure to OCREVUS. However, transient peripheral B-cell depletion and lymphocytopenia have been reported in infants born to mothers exposed to other anti-CD20 antibodies during pregnancy. OCREVUS is a humanized monoclonal antibody of an immunoglobulin G1 subtype and immunoglobulins are known to cross the placental barrier.

Lactation

There are no data on the presence of ocrelizumab in human milk, the effects on the breastfed infant, or the effects of the drug on milk production. Ocrelizumab was excreted in the milk of ocrelizumab-treated monkeys. Human IgG is excreted in human milk, and the potential for absorption of ocrelizumab to lead to B-cell depletion in the infant is unknown. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for OCREVUS and any potential adverse effects on the breastfed infant from OCREVUS or from the underlying maternal condition.

Females and Males of Reproductive Potential

Women of childbearing potential should use effective contraception while receiving OCREVUS and for 6 months after the last infusion of OCREVUS.

Most Common Adverse Reactions

RMS: The most common adverse reactions in RMS trials (incidence ≥10% and >REBIF) were upper respiratory tract infections (40%) and infusion reactions (34%).

PPMS: The most common adverse reactions in PPMS trials (incidence ≥10% and >placebo) were upper respiratory tract infections (49%), infusion reactions (40%), skin infections (14%), and lower respiratory tract infections (10%).

You may report side effects to the FDA at (800) FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at (888) 835-2555.

Please see additional Important Safety Information throughout and click here for full Prescribing Information and Medication Guide.

    • OCREVUS [prescribing information]. South San Francisco, CA: Genentech, Inc. 2024.

      OCREVUS [prescribing information]. South San Francisco, CA: Genentech, Inc. 2024.

    • Hauser SL, Bar-Or A, Comi G, et al. Ocrelizumab versus interferon beta-1a in relapsing multiple sclerosis. N Engl J Med. 2017;376(3)(suppl):S6.

      Hauser SL, Bar-Or A, Comi G, et al. Ocrelizumab versus interferon beta-1a in relapsing multiple sclerosis. N Engl J Med. 2017;376(3)(suppl):S6.

    • Weber MS, Kappos L, Hauser SL, Nicholas JA, Schneble HM, Wang Q, Giovannoni G, Filippi M. The patient impact of 10 years of ocrelizumab treatment in multiple sclerosis: Long-term data from the Phase III OPERA and ORATORIO studies. Poster presented at: 39th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), October 11-13, 2023.

      Weber MS, Kappos L, Hauser SL, Nicholas JA, Schneble HM, Wang Q, Giovannoni G, Filippi M. The patient impact of 10 years of ocrelizumab treatment in multiple sclerosis: Long-term data from the Phase III OPERA and ORATORIO studies. Poster presented at: 39th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), October 11-13, 2023.

    • Data on file. Genentech, Inc. September 2023.

      Data on file. Genentech, Inc. September 2023.

    • Hauser SL, Kappos L, Montalban X, et al. Safety of ocrelizumab in multiple sclerosis: updated analysis in patients with relapsing and primary progressive multiple sclerosis. Poster presented at: 39th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS); October 11-13, 2023; Amsterdam, the Netherlands.

      Hauser SL, Kappos L, Montalban X, et al. Safety of ocrelizumab in multiple sclerosis: updated analysis in patients with relapsing and primary progressive multiple sclerosis. Poster presented at: 39th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS); October 11-13, 2023; Amsterdam, the Netherlands.

    • Data on file. Genentech, Inc. March 2023.

      Data on file. Genentech, Inc. March 2023.

    • Clinicaltrials.gov search results: ocrelizumab AND multiple sclerosis. Accessed February 14, 2023. https://www.clinicaltrials.gov/search?cond=Multiple%20Sclerosis&term=ocrelizumab

      Clinicaltrials.gov search results: ocrelizumab AND multiple sclerosis. Accessed February 14, 2023. https://www.clinicaltrials.gov/search?cond=Multiple%20Sclerosis&term=ocrelizumab

    • Clinicaltrials.gov search results: ofatumumab AND multiple sclerosis. Accessed February 14, 2023. https://www.clinicaltrials.gov/search?cond=Multiple%20Sclerosis&term=ofatumumab

      Clinicaltrials.gov search results: ofatumumab AND multiple sclerosis. Accessed February 14, 2023. https://www.clinicaltrials.gov/search?cond=Multiple%20Sclerosis&term=ofatumumab

    • Genentech: Press Releases | www.gene.com. https://www.gene.com/media/press-releases/15006/2023-10-11/new-data-for-genentechs-ocrevus-show-tha. Accessed March 29, 2023.

      Genentech: Press Releases | www.gene.com. https://www.gene.com/media/press-releases/15006/2023-10-11/new-data-for-genentechs-ocrevus-show-tha. Accessed March 29, 2023.

    • Pineda E, Sheinson D, Ng C, Bonine N, Pardo G. Adherence and persistence to disease-modifying therapies for multiple sclerosis and their impact on clinical and economic outcomes in a US claims database. Poster presented at: 73rd AAN Annual Meeting; April 17-22, 2021; virtual.

      Pineda E, Sheinson D, Ng C, Bonine N, Pardo G. Adherence and persistence to disease-modifying therapies for multiple sclerosis and their impact on clinical and economic outcomes in a US claims database. Poster presented at: 73rd AAN Annual Meeting; April 17-22, 2021; virtual.

    • De Stefano N, Giorgio A, Battaglini M, et al. Assessing brain atrophy rates in a large population of untreated multiple sclerosis subtypes. Neurology. 2010;74(23):1868​​-1876.

      De Stefano N, Giorgio A, Battaglini M, et al. Assessing brain atrophy rates in a large population of untreated multiple sclerosis subtypes. Neurology. 2010;74(23):1868​​-1876.

    • Fox RJ, Cohen JA. Multiple sclerosis: the importance of early recognition and treatment. Cleve Clin J Med. 2001;68(2):157​-171.

      Fox RJ, Cohen JA. Multiple sclerosis: the importance of early recognition and treatment. Cleve Clin J Med. 2001;68(2):157​-171.

    • Wijnands JMA, Kingwell E, Zhu F, et al. Health-care use before a first demyelinating event suggestive of a multiple sclerosis prodrome: a matched cohort study. Lancet Neurol. 2017;16(6):445​-451.

      Wijnands JMA, Kingwell E, Zhu F, et al. Health-care use before a first demyelinating event suggestive of a multiple sclerosis prodrome: a matched cohort study. Lancet Neurol. 2017;16(6):445​-451.

    • Confavreux C, Vukusic S. Natural history of multiple sclerosis: a unifying concept. Brain. 2006;129(3):606​-616.

      Confavreux C, Vukusic S. Natural history of multiple sclerosis: a unifying concept. Brain. 2006;129(3):606​-616.

    • Cree BAC, Hollenbach JA, Bove R, et al. Silent progression in disease activity-free relapsing multiple sclerosis. Ann Neurol. 2019;85(5):653​-666.

      Cree BAC, Hollenbach JA, Bove R, et al. Silent progression in disease activity-free relapsing multiple sclerosis. Ann Neurol. 2019;85(5):653​-666.

    • Kantarci OH, Lebrun C, Siva A, et al. Primary progressive multiple sclerosis evolving from radiologically isolated syndrome. Ann Neurol. 2016;79(2):288​-294.

      Kantarci OH, Lebrun C, Siva A, et al. Primary progressive multiple sclerosis evolving from radiologically isolated syndrome. Ann Neurol. 2016;79(2):288​-294.

    • Okuda DT, Siva A, Kantarci O, et al. Radiologically isolated syndrome: 5-year risk for an initial clinical event. PLoS One. 2014;9(3):e90509.

      Okuda DT, Siva A, Kantarci O, et al. Radiologically isolated syndrome: 5-year risk for an initial clinical event. PLoS One. 2014;9(3):e90509.

    • Krieger SC, Cook K, De Nino S, Fletcher M. The topographical model of multiple sclerosis: a dynamic visualization of disease course. Neurol Neuroimmunol Neuroinflamm. 2016;3(5):e279.

      Krieger SC, Cook K, De Nino S, Fletcher M. The topographical model of multiple sclerosis: a dynamic visualization of disease course. Neurol Neuroimmunol Neuroinflamm. 2016;3(5):e279.

    • Singh S, Dallenga T, Winkler A, et al. Relationship of acute axonal damage, Wallerian degeneration, and clinical disability in multiple sclerosis. J Neuroinflammation. 2017;14(1):57.

      Singh S, Dallenga T, Winkler A, et al. Relationship of acute axonal damage, Wallerian degeneration, and clinical disability in multiple sclerosis. J Neuroinflammation. 2017;14(1):57.

    • Koch MW, Mostert J, Greenfield J, Liu WQ, Metz L. Gadolinium enhancement on cranial MRI in multiple sclerosis is age dependent. J Neurol. 2020;267(9):2619​​-2624.

      Koch MW, Mostert J, Greenfield J, Liu WQ, Metz L. Gadolinium enhancement on cranial MRI in multiple sclerosis is age dependent. J Neurol. 2020;267(9):2619​​-2624.

    • Walton C, King R, Rechtman L, et al. Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS, third edition. Mult Scler. 2020;26(14):1816​​-1821.

      Walton C, King R, Rechtman L, et al. Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS, third edition. Mult Scler. 2020;26(14):1816​​-1821.

    • Dutta R, Trapp BD. Mechanisms of neuronal dysfunction and degeneration in multiple sclerosis. Prog Neurobiol. 2011;93(1):1-12.

      Dutta R, Trapp BD. Mechanisms of neuronal dysfunction and degeneration in multiple sclerosis. Prog Neurobiol. 2011;93(1):1-12.

    • Kamel F. Factors involved in relapse of multiple sclerosis. J Microsc and Ultrastruct. 2019;7(3):103​-108.

      Kamel F. Factors involved in relapse of multiple sclerosis. J Microsc and Ultrastruct. 2019;7(3):103​-108.

    • Krieger SC, Sumowski J. New insights into multiple sclerosis clinical course from the topographical model and functional reserve. Neurol Clin. 2018;36(1):13-25.

      Krieger SC, Sumowski J. New insights into multiple sclerosis clinical course from the topographical model and functional reserve. Neurol Clin. 2018;36(1):13-25.

    • Zeydan B, Kantarci OH. Progressive forms of multiple sclerosis: distinct entity or age-dependent phenomena. Neurol Clin. 2018;36(1):163​-171.

      Zeydan B, Kantarci OH. Progressive forms of multiple sclerosis: distinct entity or age-dependent phenomena. Neurol Clin. 2018;36(1):163​-171.

    • De Stefano N, Narayanan S, Francis GS, et al. Evidence of axonal damage in the early stages of multiple sclerosis and its relevance to disability. Arch Neurol. 2001;58(1):65-70.

      De Stefano N, Narayanan S, Francis GS, et al. Evidence of axonal damage in the early stages of multiple sclerosis and its relevance to disability. Arch Neurol. 2001;58(1):65-70.

    • Hawker K. Progressive multiple sclerosis: characteristics and management. Neurol Clin. 2011;29(2):423​-434.

      Hawker K. Progressive multiple sclerosis: characteristics and management. Neurol Clin. 2011;29(2):423​-434.

    • Mori F, Rossi S, Piccinin S, et al. Synaptic plasticity and PDGF signaling defects underlie clinical progression in multiple sclerosis. J Neurosci. 2013;33(49):19112​​​-19119.

      Mori F, Rossi S, Piccinin S, et al. Synaptic plasticity and PDGF signaling defects underlie clinical progression in multiple sclerosis. J Neurosci. 2013;33(49):19112​​​-19119.

    • Ziemssen T, Derfuss T, de Stefano N, et al. Optimizing treatment success in multiple sclerosis. J Neurol. 2016;263(6):1053​​-1065.

      Ziemssen T, Derfuss T, de Stefano N, et al. Optimizing treatment success in multiple sclerosis. J Neurol. 2016;263(6):1053​​-1065.

    • Kremenchutzky M, Rice GPA, Baskerville J, Wingerchuk DM, Ebers GC. The natural history of multiple sclerosis: a geographically based study 9: observations on the progressive phase of the disease. Brain. 2006;129(3):584​-594.

      Kremenchutzky M, Rice GPA, Baskerville J, Wingerchuk DM, Ebers GC. The natural history of multiple sclerosis: a geographically based study 9: observations on the progressive phase of the disease. Brain. 2006;129(3):584​-594.

    • Tur C, Carbonell-Mirabent P, Cobo-Calvo A, et al. Association of early progression independent of relapse activity with long-term disability after a first demyelinating event in multiple sclerosis. JAMA Neurol. 2023;80(2)151​-160.

      Tur C, Carbonell-Mirabent P, Cobo-Calvo A, et al. Association of early progression independent of relapse activity with long-term disability after a first demyelinating event in multiple sclerosis. JAMA Neurol. 2023;80(2)151​-160.

    • Kappos L, Wolinsky JS, Giovannoni G, et al. C Contribution of relapse-independent progression vs relapse-associated worsening to overall confirmed disability accumulation in typical relapsing multiple sclerosis in a pooled analysis of 2 randomized clinical trials. JAMA Neurol. 2020;77(9):1132​-1140.

      Kappos L, Wolinsky JS, Giovannoni G, et al. C Contribution of relapse-independent progression vs relapse-associated worsening to overall confirmed disability accumulation in typical relapsing multiple sclerosis in a pooled analysis of 2 randomized clinical trials. JAMA Neurol. 2020;77(9):1132​-1140.

    • Portaccio E, Bellinvia, A, Fonderico M, et al. Progression is independent of relapse activity in early multiple sclerosis: a real-life cohort study. Brain. 2022;145:2796​-2805.

      Portaccio E, Bellinvia, A, Fonderico M, et al. Progression is independent of relapse activity in early multiple sclerosis: a real-life cohort study. Brain. 2022;145:2796​-2805.

    • Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33(11):1444​​-1452.

      Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33(11):1444​​-1452.

    • Strik M, Shanahan CJ, van der Walt A, et al. Functional correlates of motor control impairments in multiple sclerosis: a 7 Tesla task functional MRI study. Hum Brain Mapp. 2021;42(8):2569​​-2582.

      Strik M, Shanahan CJ, van der Walt A, et al. Functional correlates of motor control impairments in multiple sclerosis: a 7 Tesla task functional MRI study. Hum Brain Mapp. 2021;42(8):2569​​-2582.

    • Krieger S, Sumowski J. Subclinical burden of multiple sclerosis at EDSS 0. Mult Scler J. 2021;27(2S):3-133.

      Krieger S, Sumowski J. Subclinical burden of multiple sclerosis at EDSS 0. Mult Scler J. 2021;27(2S):3-133.

    • Watson TM, Ford E, Worthington E, Lincoln NB. Validation of mood measures for people with multiple sclerosis. Int J MS Care. 2014;16(2):105-109.

      Watson TM, Ford E, Worthington E, Lincoln NB. Validation of mood measures for people with multiple sclerosis. Int J MS Care. 2014;16(2):105-109.

    • Javůrková A, Zimová D, Tomašovičová K, Raudenská J. Cognitive deficits and neuropsychological assessment in multiple sclerosis. In: Gonzalez-Quevedo A, ed. Trending Topics in Multiple Sclerosis. IntechOpen: 2016:211​-226.

      Javůrková A, Zimová D, Tomašovičová K, Raudenská J. Cognitive deficits and neuropsychological assessment in multiple sclerosis. In: Gonzalez-Quevedo A, ed. Trending Topics in Multiple Sclerosis. IntechOpen: 2016:211​-226.

    • van Munster CE, Uitdehaag BM. Outcome measures in clinical trials for multiple sclerosis. CNS Drugs. 2017;31(3):217-236.

      van Munster CE, Uitdehaag BM. Outcome measures in clinical trials for multiple sclerosis. CNS Drugs. 2017;31(3):217-236.

    • Ontaneda D, Tallantyre E, Kalincik T, Planchon SM, Evangelou N. Early highly effective versus escalation treatment approaches in relapsing multiple sclerosis. Lancet Neurol. 2019;18(10):973​-980.

      Ontaneda D, Tallantyre E, Kalincik T, Planchon SM, Evangelou N. Early highly effective versus escalation treatment approaches in relapsing multiple sclerosis. Lancet Neurol. 2019;18(10):973​-980.

    • Simpson A, Mowry EM, Newsome SD. Early aggressive treatment approaches for multiple sclerosis. Curr Treat Options Neurol. 2021;23(7):19.

      Simpson A, Mowry EM, Newsome SD. Early aggressive treatment approaches for multiple sclerosis. Curr Treat Options Neurol. 2021;23(7):19.

    • Spelman T, Magyari M, Piehl F, et al. Treatment escalation vs immediate initiation of highly effective treatment for patients with relapsing-remitting multiple sclerosis: data from 2 different national strategies. JAMA Neurol. 2021;78(10):1197.

      Spelman T, Magyari M, Piehl F, et al. Treatment escalation vs immediate initiation of highly effective treatment for patients with relapsing-remitting multiple sclerosis: data from 2 different national strategies. JAMA Neurol. 2021;78(10):1197.

    • Hauser SL, Bar-Or A, Comi G, et al. Ocrelizumab versus interferon beta-1a in relapsing multiple sclerosis. N Engl J Med. 2017;376(3): 221​-234.

      Hauser SL, Bar-Or A, Comi G, et al. Ocrelizumab versus interferon beta-1a in relapsing multiple sclerosis. N Engl J Med. 2017;376(3): 221​-234.

    • The Official Journal of the Academy of Oncology Nurse & Patient Navigators. The importance of medication adherence in patients with chronic hematologic malignancies. Accessed February 23, 2022. https://jons-online.com/special-issues-andsupplements/2019/best-practices-in-hematologic-malignancies-december-2019-vol-10/2729-the-importance-of-medication-adherence-inpatients-with-chronic-hematologic-malignancies

      The Official Journal of the Academy of Oncology Nurse & Patient Navigators. The importance of medication adherence in patients with chronic hematologic malignancies. Accessed February 23, 2022. https://jons-online.com/special-issues-andsupplements/2019/best-practices-in-hematologic-malignancies-december-2019-vol-10/2729-the-importance-of-medication-adherence-inpatients-with-chronic-hematologic-malignancies

    • Morillo Verdugo R, Ramirez Herraiz E, Fernandez-Del Olmo R, Roig Bonet M, Valdivia Garcia M. Adherence to disease-modifying treatments in patients with multiple sclerosis in Spain. Patient Prefer Adherence. 2019;13:261​-272.

      Morillo Verdugo R, Ramirez Herraiz E, Fernandez-Del Olmo R, Roig Bonet M, Valdivia Garcia M. Adherence to disease-modifying treatments in patients with multiple sclerosis in Spain. Patient Prefer Adherence. 2019;13:261​-272.

    • Data on file. Genentech, Inc. March 2021.

      Data on file. Genentech, Inc. March 2021.

    • Baker D, Marta M, Pryce G, Giovannoni G, Schmierer K. Memory B cells are major targets for effective immunotherapy in relapsing multiple sclerosis. EBioMedicine. 2017;16:41-50.

      Baker D, Marta M, Pryce G, Giovannoni G, Schmierer K. Memory B cells are major targets for effective immunotherapy in relapsing multiple sclerosis. EBioMedicine. 2017;16:41-50.

    • Data on File. Genentech, Inc. October 2020.

      Data on File. Genentech, Inc. October 2020.

    • Turner B, Cree BAC, Kappos L, et al. Ocrelizumab efficacy in subgroups of patients with relapsing multiple sclerosis. J Neurol. 2019;266(5):1182​​-1193.

      Turner B, Cree BAC, Kappos L, et al. Ocrelizumab efficacy in subgroups of patients with relapsing multiple sclerosis. J Neurol. 2019;266(5):1182​​-1193.

    • Data on file. Genentech, Inc. February 2022.

      Data on file. Genentech, Inc. February 2022.

    • Traboulsee A, Hauser SL, Havrdov E, et al. Efficacy of ocrelizumab on brain MRI outcomes in patients with early relapsing multiple sclerosis: pooled analysis of the OPERA studies. Presented at: 69th American Academy of Neurology (AAN) Annual Meeting; April 22-28, 2017; Boston, MA. Poster 338.

      Traboulsee A, Hauser SL, Havrdov E, et al. Efficacy of ocrelizumab on brain MRI outcomes in patients with early relapsing multiple sclerosis: pooled analysis of the OPERA studies. Presented at: 69th American Academy of Neurology (AAN) Annual Meeting; April 22-28, 2017; Boston, MA. Poster 338.

    • Treaba CA, Balasa R, Podeanu DM, et al. Cerebral lesions of multiple sclerosis: is gadolinium always irreplaceable in assessing lesion activity? Diagn Interv Radiol. 2014;20:178​-184.

      Treaba CA, Balasa R, Podeanu DM, et al. Cerebral lesions of multiple sclerosis: is gadolinium always irreplaceable in assessing lesion activity? Diagn Interv Radiol. 2014;20:178​-184.

    • Hauser SL, Kappos L, Arnold DL, et al. Five years of ocrelizumab in relapsing multiple sclerosis: OPERA studies open-label extension. Neurology. 2020;29(13)e1854-e1867.

      Hauser SL, Kappos L, Arnold DL, et al. Five years of ocrelizumab in relapsing multiple sclerosis: OPERA studies open-label extension. Neurology. 2020;29(13)e1854-e1867.

    • Data on File. Genentech, Inc. April 2019.

      Data on File. Genentech, Inc. April 2019.

    • Hauser SL, Kappos L, Montalban X, et al. Long-term reduction in 48-week confirmed disability progression after 5 years of ocrelizumab treatment in patients with relapsing multiple sclerosis. Presented at: 5th Congress of the European Academy of Neurology (EAN); June 29-July 2, 2019; Oslo, Norway.

      Hauser SL, Kappos L, Montalban X, et al. Long-term reduction in 48-week confirmed disability progression after 5 years of ocrelizumab treatment in patients with relapsing multiple sclerosis. Presented at: 5th Congress of the European Academy of Neurology (EAN); June 29-July 2, 2019; Oslo, Norway.

    • Data on file. Genentech, Inc. April 2023.

      Data on file. Genentech, Inc. April 2023.

    • Havrdová E, Arnold DL, Bar-Or A, et al. No evidence of disease activity (NEDA) analysis by epochs in patients with relapsing multiple sclerosis treated with ocrelizumab vs interferon beta-1a. Mult Scler J Exp Transl Clin. 2018;4(1): 2055​2173​1876​0642.

      Havrdová E, Arnold DL, Bar-Or A, et al. No evidence of disease activity (NEDA) analysis by epochs in patients with relapsing multiple sclerosis treated with ocrelizumab vs interferon beta-1a. Mult Scler J Exp Transl Clin. 2018;4(1): 2055​2173​1876​0642.

    • Montalban X, Hauser SL, Kappos L, et al. Ocrelizumab versus placebo in primary progressive multiple sclerosis. N Engl J Med. 2017;376(3):209​-220.

      Montalban X, Hauser SL, Kappos L, et al. Ocrelizumab versus placebo in primary progressive multiple sclerosis. N Engl J Med. 2017;376(3):209​-220.

    • De Seze J, Arnold DL, Bar-Or A, et al. Infusion-related reactions with ocrelizumab in relapsing multiple sclerosis and primary progressive multiple sclerosis. Presented at: 32nd Congress of the European Committee for Treatment and Research of Multiple Sclerosis; September 14-17, 2016; London, United Kingdom.

      De Seze J, Arnold DL, Bar-Or A, et al. Infusion-related reactions with ocrelizumab in relapsing multiple sclerosis and primary progressive multiple sclerosis. Presented at: 32nd Congress of the European Committee for Treatment and Research of Multiple Sclerosis; September 14-17, 2016; London, United Kingdom.

    • Hauser SL, Kappos L, Montalban X, et al. Safety of ocrelizumab in patients with relapsing and primary progressive multiple sclerosis. Neurology. 2021;97(16):e1546-e1559.

      Hauser SL, Kappos L, Montalban X, et al. Safety of ocrelizumab in patients with relapsing and primary progressive multiple sclerosis. Neurology. 2021;97(16):e1546-e1559.

    • Data on file. Genentech, Inc. November 2022.

      Data on file. Genentech, Inc. November 2022.

    • Data on file. Genentech, Inc. November 2022.

      Data on file. Genentech, Inc. November 2022.

    • Hauser SL, Kappos L, Montalban X, et al. Safety of ocrelizumab in multiple sclerosis: updated analysis in patients with relapsing and primary progressive multiple sclerosis. Poster presented at: 37th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS); October 13-15, 2021. (Suppl).

      Hauser SL, Kappos L, Montalban X, et al. Safety of ocrelizumab in multiple sclerosis: updated analysis in patients with relapsing and primary progressive multiple sclerosis. Poster presented at: 37th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS); October 13-15, 2021. (Suppl).

    • Data on file. Genentech, Inc. November 2021.

      Data on file. Genentech, Inc. November 2021.

    • American Cancer Society. American Cancer Society guidelines for the early detection of cancer. Updated July 30, 2020. Accessed February 1, 2022. https://www.cancer.org/healthy/find-cancer-early/cancer-screening-guidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html

      American Cancer Society. American Cancer Society guidelines for the early detection of cancer. Updated July 30, 2020. Accessed February 1, 2022. https://www.cancer.org/healthy/find-cancer-early/cancer-screening-guidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html

    • National Cancer Institute. Overview of the SEER program. Accessed October 17, 2022. https://seer.cancer.gov/about/overview.html

      National Cancer Institute. Overview of the SEER program. Accessed October 17, 2022. https://seer.cancer.gov/about/overview.html

    • Hartung HP; ENSEMBLE Steering Committee members and study investigators. Ocrelizumab shorter infusion: Primary results from the ENSEMBLE PLUS substudy in patients with MS. Neurol Neuroimmunol Neuroinflamm. 2020;7(5):e807

      Hartung HP; ENSEMBLE Steering Committee members and study investigators. Ocrelizumab shorter infusion: Primary results from the ENSEMBLE PLUS substudy in patients with MS. Neurol Neuroimmunol Neuroinflamm. 2020;7(5):e807

    • Data on File. Genentech, Inc. October 2020.

      Data on File. Genentech, Inc. October 2020.

    • Mayer L, Kappos L, Racke MK, et al. Ocrelizumab infusion experience in patients with relapsing and primary progressive multiple sclerosis: results from the phase 3 randomized OPERA I, OPERA II, and ORATORIO studies. Mult Scler Relat Disord. 2019;30:236​-243.

      Mayer L, Kappos L, Racke MK, et al. Ocrelizumab infusion experience in patients with relapsing and primary progressive multiple sclerosis: results from the phase 3 randomized OPERA I, OPERA II, and ORATORIO studies. Mult Scler Relat Disord. 2019;30:236​-243.