Practical aspects of treatment with ocrelizumab in patients with multiple sclerosis Review article
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Abstract
Ocrelizumab is a registered drug for the treatment of adult patients with active relapsing and early primary progressive multiple sclerosis. This article presents a proposal for a treatment protocol for ocrelizumab based on the current summary of product characteristics, the recommendations of German experts (Krankheitsbezogenen Kompetenznetz Multiple Sklerose) and the authors’ own experience. The protocol consists of three parts. The first of them discusses issues analyzed before treatment onset – indications for therapy, contraindications, planned laboratory and imaging tests, termination of vaccinations, pregnancy and breastfeeding, and change from previous disease modifying therapy to ocrelizumab. Then, in the second part, the individual stages of drug administration are presented – preparation of the infusion room, consideration of temporary withdrawal of antihypertensive drugs, exclusion of infection, premedication, infusion of ocrelizumab and monitoring during the infusion. Finally, the third part deals with therapy monitoring and other issues such as hypogammaglobulinemia, vaccinations, cancer screening, new clinical and/or radiological symptoms during treatment, and the duration of therapy.
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