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MS – Ocrelizumab and Mild Hypogammaglobulinaemia — SCE Neurology MCQ

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HardMultiple Sclerosis & CNS InflammationMS – Ocrelizumab and Mild HypogammaglobulinaemiaSCE Neurology

A 32-year-old with active multiple sclerosis is due to start ocrelizumab. She is non-immune to measles and requires a live MMR vaccine. There is no urgency requiring immediate anti-CD20 treatment. What is the most appropriate plan?

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Correct answer: E — Give MMR first and delay ocrelizumab until at least six weeks after immunisation

Required vaccination should be completed at least six weeks before ocrelizumab begins. A four-week interval is therefore too short for this medicine. Live vaccines are not recommended during treatment until B-cell repletion because immunogenicity and safety may be impaired, so neither the interval between loading infusions nor a fixed three- or twelve-month post-infusion interval is a substitute for the stated pre-treatment sequence and post-treatment immune recovery.

Reference: Ocrevus Summary of Product Characteristics: https://www.medicines.org.uk/emc/product/8898/smpc