MS Drugs and Severe Form of West Nile Virus Infection

Stuart SchlossmanMS Pain and Side Effects, Multiple Sclerosis

 Researchers link ocrelizumab to increased risk of a rare and serious form of mosquito-borne infection.

By Trevis Gleason –  Reviewed: September 8, 2023

All drugs come with both benefits and risks.

For people with multiple sclerosis (MS) who take anti-CD20 therapies — which include ocrelizumab (Ocrevus), ofatumumab (Kesimpta), rituximab (Rituxan), and ublituximab (Briumvi) — the primary benefit is fewer relapses and less disability progression.

One potential downside is a higher risk of infection, especially over the long term, as noted in this NeurologyLive peer exchange.

Neuroinvasive West Nile Virus

Now a paper published in the journal Neurology finds that people with MS being treated with ocrelizumab could be as much as 258 times more likely than the average population to contract neuroinvasive West Nile virus.

What’s neuroinvasive West Nile virus? It’s West Nile virus — currently the leading cause of mosquito-borne disease in the United States — that infects the nervous system, particularly the central nervous system (brain and spinal cord).

The researchers found only four people, all women, out of a pool of 2,009 people with MS on ocrelizumab, who developed neuroinvasive West Nile virus. But that was compared with the entire populations of Pennsylvania and New Jersey, where only a total of 86 people were diagnosed with neuroinvasive West Nile virus during the study period.

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