Could Shortened Infusion Times for Ocrevus Become a Reality?
Users of the disease-modifying therapy Ocrevus (ocrelizumab) share a common complaint: the length of time the infusions take. It may seem petty, but an Ocrevus infusion consumes nearly an entire day.
My typical infusion involves checking into the clinic, being screened by the infusion nurse for any changes, taking my basic vital signs, setting up an intravenous infusion line, administering Benadryl and a small dose of IV Solu-Medrol, and then waiting for the Ocrevus to arrive from the clinic pharmacy. Once the treatment arrives, it takes another 3 1/2 hours for the actual infusion, followed by an hour of post-infusion observation before I am allowed to leave. My clinic recommends allowing a minimum of six hours for this appointment.
Currently, after the initial induction doses, which are spaced two weeks apart, people with MS get these treatments every six months. Each infusion is stretched over a long period of time to monitor the person receiving the therapy for any allergic reactions or other adverse effects. The U.S. Food and Drug Administration approved the recommended infusion rate of 3 1/2 hours for Ocrevus, but that time does not include pre- and post-infusion setup and observation.
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Research on shorter infusion times
Research shared at this year’s Consortium of Multiple Sclerosis Centers Annual Meeting in Seattle, Washington, might help change this infusion time. According to a poster titled, “Evaluation of Shorter Infusion Times with Ocrelizumab in Patients with Relapsing-Remitting Multiple Sclerosis,” researchers found in preliminary data from clinical trials that people who were given ocrelizumab infusions in a shorter amount of time had no additional reaction problems to the infusion as those who received the treatment over the prescribed 3 1/2 hour administration.
In an interview with Hideki Garren, MD, PhD, the global head of multiple sclerosis and neuroimmunology for Genentech, I had the opportunity to learn more about this study. Genentech is the pharmaceutical maker of Ocrevus.
“The Ocrevus infusion time is 3 1/2 hours, but it really takes away your whole day. We’re trying to reduce the infusion time to two hours if possible. Everyone has the first infusion done slowly to monitor for an adverse effect. First and foremost is patient safety, we don’t want to do anything that isn’t safe for the patient,” Dr. Garren said.
The poster shared preliminary results of an extension study of the CHORDS clinical trial (NCT02637856) and the SaROD trial (NCT03606460). The original CHORDS study was with patients who were new to taking ocrelizumab after having had less than desirable results on other disease-modifying therapies.
The look at shortened infusion times was a sub-study of the CHORDS patient cohort that already had completed the clinical trial to prove the safety and efficacy of ocrelizumab. The shortened infusion time for this group began at their fifth full therapy infusion. Note, this is actually the sixth infusion because the first dose is split into two infusions, given two weeks apart.
So far, the results from the preliminary data look promising. I know I would be thrilled if my infusion clinic visits didn’t consume my entire day. Even though the current infusion time seems like a small sacrifice to slow our MS, most of us just want to be done and get on with our lives.
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Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, Bionews Services, and are intended to spark discussion about issues pertaining to multiple sclerosis.
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Pik
My first two lasted 7 to 8 hours at hospital at the cutthroat rate 125 k each. Hated it there. Insurance wouldn't pay that price anymore, now go to Arthritis/Osteoporosis center. 5 hours now,better facility, cost 60k.Major difference.
Keith Layton
Please- powers that be- follow what you observe and not your SOP's! First of all- thank goodness I have never been given Solu-Medrol prior to infusion. I have only been given Benedryl. I know folks who have had it though and it seems to be an "over-the-top" precaution and especially if 1. you have not had any infusion reactions and 2. Solu-Medrol or similar drives you up a wall as it does for me. Anyway, it's boring as hell and the infusion is slower than.....well- it's slow. I have never waited more than 15 minutes after and the last 3 infusions I signed a waiver and left immediately. After all, I'm from California and have to beat the traffic! All seriousness aside, for those who have not had adverse reactions, give us a break and let the flow flow quicker.
Caroline Borduin
I agree that the infusions take FOREVER! And I've had no adverse reactions at all, so if the data says Ocrevus can be administered more quickly, I am all for it.
Heidi Fuhrmeister
I have had four infusions so far. Started Ocrevus in the fall of 2017.I feel blessed that I have had no side affects at all. I am retired so I have no problem with giving a day to get medicated for my MS.Plus I don't have to think about taking meds everyday! That is one of the best things about Ocrevus, but the BEST thing about Ocrevus is I swear, I am feeling so much better. I had an appt. with my Neurologist last week and I brought in a spreadsheet of all the MS symptoms that were better or almost gone (brain fog!). She was not impressed: (. I did ask her if any of her other patients on Ocrevus were doing better and she said, cautiously, yes some. Again I was a bit disappointed in her lack of enthusiasm but I feel better and that is all that counts as far as I am concerned!
Heidi Fuhrmeister
Mer
I was on Tysabri before I switched to Ocrevus, so six months versus monthly was a happy change. I always schedule my infusions first thing in the morning, but I would be happy to have anything that could shorten the process.
Traci Easton
That sounds like a plan,in my opinion. I used to have Tysabri infusions every 4 weeks,(a few years ago) and I never had any adverse reaction to that DMT either. I hope that after so many infusions, it would be possible to shorten the waiting period before I could be released to go back to my life.I understand that some people have reactions to the DMT,but for those who don't have the reaction should be shortened to 30 minutes. Same with the waiting period before the infusion itself.
Tom
Let’s not forget how serious these drugs are and their potential risks/side effects. They are very aggressive and can easily shock our already misguided immune systems. I am just fine with the pre infusion protocols, slow drip, and 1 hour post infusion observation.
Senator
12 hrs per year is a big win for me,along with other hosp stuff 0f 1hr per visit, 1hr round trip hosp = 16 hrs per year. Since I used to take Solumedrol, Sol was a 1hr infusion, along with round trip to hosp 1hr, and other misc hosp check in etc 1/2 hr for total 2 1/2 hrs, 5 times = 12 1/2 hrs. This all times 4 per year = 50 hrs. Time spent is a lot less so I am happy overall.
Jennifer Austin
I have had slight allergic reactions during each of my 3 Ocrevus infusions so far (itchy mouth and ears). Even though this means they stop the infusion, give me Benadryl and call my neurologist for approval to continue (all of which takes extra time of course) I don’t mind the length of treatment time. I am happy not to have to give myself shots for other meds and appreciate the caution shown by medical staff while getting the infusion.
Susy Gidda
Has anyone felt depressed after theinfusion ?
Thx