Infection screening prior to Ocrelizumb initiation in patients with Multiple Sclerosis (MS): Concise clinical recommendation based on a modified Delphi consensus on behalf of the Iranian MS -infectious disease group

Abstract

Recent scientific literature has addressed the risk of infection associated with ocrelizumab in patients with multiple sclerosis (PwMS). To assist Iranian physicians with decision-making about these risks, a modified Delphi consensus process was conducted. A panel of experts, including MS experts, infectious disease specialists, and gastrointestinal specialists, created clinically relevant, evidence-based recommendations. These recommendations addressed the screening and management strategies for the early identification of tuberculosis, varicella-zoster virus infection, hepatitis B and C virus infection, human immunodeficiency virus infection, secondary hypogammaglobulinemia, vaccination, and required laboratory tests before ocrelizumab infusion in PwMS scheduled to start ocrelizumab. In total, the panel recommended 67 statements to be considered in daily practice for screening before starting ocrelizumab, prophylaxis where appropriate, monitoring, and early treatment of infections in PwMS treated with ocrelizumab.