Ocrevus Zunovo: The Latest FDA-Approved Injection for MS
Multiple Sclerosis (MS) is a chronic, often disabling disease affecting the central nervous system. Disease-modifying therapies (DMTs) are crucial for managing MS and slowing progression. On September 13, 2024, the FDA approved Ocrevus Zunovo™ (ocrelizumab and hyaluronidase-ocsq) for adults with relapsing forms of MS (RMS) and primary progressive MS (PPMS). This subcutaneous injection offers a major convenience improvement over the standard intravenous (IV) Ocrevus infusion.
How does Ocrevus Zunovo work?
Ocrevus Zunovo contains ocrelizumab, a monoclonal antibody that targets CD20-positive B cells, which are believed to contribute to MS nerve damage. By depleting these B cells, the therapy reduces the immune attack on the central nervous system. The Zunovo formulation uses Halozyme Therapeutics' Enhanze® technology, including a hyaluronidase enzyme that aids rapid dispersion and absorption of ocrelizumab from a subcutaneous injection site.
The Patient Experience: A Leap in Convenience
The administration method is key when choosing an MS therapy. Ocrevus Zunovo significantly improves this:
- Reduced Administration Time: Subcutaneous injection takes about 10 minutes, a dramatic decrease from the IV infusion.
- Flexibility: Faster administration may allow treatment in various clinical settings, potentially increasing access.
- Twice-Yearly Dosing: Like the IV version, it is given twice a year, offering less frequent dosing than many other injections.
- Maintained Efficacy: The OCARINA II trial showed the subcutaneous injection was comparable to the IV infusion in drug exposure and efficacy.
Comparison of Modern Injectable MS Therapies
Several injectable DMTs are available. Here is a comparison of Ocrevus Zunovo with other treatments:
| Feature | Ocrevus Zunovo (ocrelizumab/hyaluronidase) | Kesimpta (ofatumumab) | Briumvi (ublituximab-xiiy) |
|---|---|---|---|
| Administration Route | Healthcare professional (HCP)-administered subcutaneous injection | Patient self-administered subcutaneous injection | HCP-administered intravenous (IV) infusion |
| Frequency | Twice yearly (every 6 months) | Monthly, after initial dosing | Twice yearly (every 6 months) after initial dosing |
| Typical Administration Time | ~10 minutes (actual clinic time varies) | Varies (self-administered) | 1 to 4 hours |
| Target Population | Relapsing forms of MS and PPMS | Relapsing forms of MS | Relapsing forms of MS |
| Key Mechanism | CD20-directed B-cell depletion | CD20-directed B-cell depletion | CD20-directed B-cell depletion |
Emerging Injectable Treatments on the Horizon
Research continues to develop new injectable MS therapies. Bruton's tyrosine kinase (BTK) inhibitors, such as Tolebrutinib and Fenebrutinib, are a promising class.
- BTK Inhibitors: These small molecules can cross the blood-brain barrier, targeting immune cells, including B cells and microglia, within the central nervous system. Tolebrutinib has shown potential in clinical trials for slowing disability progression.
- Frexalimab: Another investigational therapy, frexalimab, is being studied in subcutaneous and intravenous forms and has shown early effectiveness in reducing disease activity and new MRI lesions.
Considering Your Treatment Options
Choosing an MS treatment involves discussion with a healthcare provider. Ocrevus Zunovo offers a convenient HCP-administered option. Other options like monthly self-injections of Kesimpta or the twice-yearly Briumvi infusion may be more suitable for some. BTK inhibitors offer a new dimension, especially for progressive forms. Your neurologist will help you decide based on your specific MS type, disease activity, and lifestyle.
Conclusion
Ocrevus Zunovo's introduction as a subcutaneous injection is a significant step, offering a more convenient, less time-consuming option for relapsing and primary progressive MS. Alongside emerging therapies like BTK inhibitors, this highlights ongoing progress in MS research. The best treatment depends on individual health needs and should be determined with a healthcare team. Resources like the {Link: National Multiple Sclerosis Society website https://www.nationalmssociety.org/news-and-magazine/news/fda-approves-ocrevus-zunovo} can provide further information.
