Zeposia vs. Ocrevus for Multiple Sclerosis: Important Differences and Potential Risks.

Key takeaways

Zeposia (ozanimod) and Ocrevus (ocrelizumab) are both medications used to treat multiple sclerosis (MS). However, they belong to different medication classes and have distinct uses and administration methods. Zeposia is a sphingosine 1-phosphate receptor modulator taken orally, while Ocrevus is a monoclonal antibody given as an infusion. Zeposia is also approved for treating moderate-to-severe ulcerative colitis (UC), whereas Ocrevus is the only FDA-approved medication for primary progressive MS. Zeposia is taken daily, with a starter pack to gradually increase the dose, while Ocrevus is administered every six months after initial doses. Common side effects of Zeposia include upper respiratory infections and liver enzyme changes, while Ocrevus can cause infusion reactions and upper respiratory tract infections. Both medications can increase the risk of infections. Rarely, Ocrevus may increase your risk of some types of cancers.

Zeposia

(ozanimod)

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Ocrevus

(ocrelizumab)

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Summary for Zeposia

Prescription only

Zeposia (ozanimod) treats adults with relapsing forms of multiple sclerosis (MS). This medication can also treat adults with ulcerative colitis (UC). It works as a sphingosine 1-phosphate (S1P) receptor modulator to relieve inflammation in the body. It's a capsule you take by mouth, usually once per day (or as directed by your prescriber if you have liver problems). You use a starter pack for the first week. It helps you slowly raise your dosage to a maintenance level. Side effects include upper respiratory infections and higher liver enzymes. Zeposia (ozanimod) is only available as a brand-name medication.

Indications for Zeposia

Relapsing forms of multiple sclerosis (MS) in adults
Moderate-to-severe ulcerative colitis (UC) in adults

Pros and Cons for Zeposia

Pros

Taken by mouth, with or without food
Taken once a day
Starter pack available to help guide dosing at the beginning of treatment

Cons

Might raise your risk of infections
Not safe for people with certain heart problems or severe liver problems
Not approved for children

Common Side Effects for Zeposia

Upper respiratory infection (26%)
High liver enzyme levels (10%)

Warnings for Zeposia

Risk of infections
Risk of brain infection (progressive multifocal leukoencephalopathy)
Slow heart rate and heart rhythm
Higher blood pressure
Liver damage
Breathing problems
Eye problem called macular edema
Brain problem called posterior reversible encephalopathy syndrome (PRES)
Possible risk of skin cancer
Harm to an unborn baby

Summary for Ocrevus

Prescription only

Ocrevus (ocrelizumab) is used to treat multiple sclerosis (MS) in adults. It can also treat certain children 10 years and older with relapsing-remitting MS. Ocrevus (ocrelizumab) is a type of monoclonal antibody. It's given as an infusion through the vein every 6 months at a medical center or clinic. A trained healthcare professional will help give Ocrevus (ocrelizumab) to you. Side effects can include a higher risk of infections and infusion reactions.

Indications for Ocrevus

All types of multiple sclerosis (MS) in adults
Relapsing-remitting MS in children 10 years and older who weigh at least 55 lbs

Pros and Cons for Ocrevus

Pros

Given twice a year (after a couple starter doses)
Can help lessen the number of MS relapses
Approved for all types of MS in adults
Also approved for MS in certain children ages 10 years and older
Might be better tolerated than some other injectable MS medications

Cons

Must be given as an infusion through the vein
Each infusion takes a few hours
Can cause infusion reactions (like itching, flushing, nausea, and fast heartbeat)
Can raise your risk of infections
Doesn't cure MS