Diplomat Pharmacy, the largest independent specialty pharmacy in the U.S., has been selected to dispense Ocrevus (ocrelizumab), a limited-distribution drug, to people with relapsing and primary progressive multiple sclerosis.
Ocrevus was approved by the U.S. Food and Drug Administration on March 28, becoming the first therapy approved for both RMS and PPMS — and the first therapy ever indicated as a primary progressive MS treatment. It was developed by Genentech, a member of the Roche Group, and is expected to be available by mid-April.
“We are excited to make this highly anticipated treatment option available to patients in need,” Paul Urick, Diplomat’s president, said in a press release. “Ocrevus can reduce the burden of multiple sclerosis and give patients hope.”
Ocrevus is a monoclonal antibody targeting B-cells (a type of immune cell) that express a protein called CD20 on their surface. CD20-positive B-cells are thought to directly cause damage to the myelin sheath — an insulating layer allowing signals to pass swiftly through neuronal extensions, known as axons. That damage initiates a series of immune reactions that debilitate MS patients.
Studies have shown that Ocrevus binds to B-cells with CD20 markers but not to stem cells or plasma cells, so as to preserve key immune functions.
A story about the development of Ocrevus and its mechanism of action can be found on this link. The treatment is given every six months by intravenous infusion.
Relapsing multiple sclerosis is the most common form of this disease, affecting around 85 percent of all patients. It is marked by flares, or relapses, defined as the appearance of new symptoms or the return of previous symptoms for 24 hours or more. Patients experience inflammatory attacks on nerve fibers and the myelin sheaths that protect them.
Up to 10% of people with MS are diagnosed with primary progressive MS, so named because it progresses from the onset of the first (primary) symptoms. PPMS symptoms steadily worsen over time without relapses or remissions.
MS is estimated to affect more than 2.3 million people worldwide, including about 400,000 people in the U.S.