Key Takeaways:

• Steroid-free administration of Ocrevus (ocrelizumab) and Briumvi (ublituximab) was well tolerated in a retrospective review of 26 patients with multiple sclerosis (MS), with 68 infusions completed without corticosteroid premedication.
• Of the 26 patients who received ocrelizumab or ublituximab without premedication, 77% of patients did not experience any infusion-related reactions (IRRs). Twenty-three percent experienced mild reactions such as an itchy throat or headache.
• Removing steroid premedication for patients with MS could shorten infusion time and reduce treatment-related side effects, improving patient safety and outcomes.

During the National Infusion Center Association (NICA) 2026 Annual Conference, Marissa Shackleton, Executive Director of The Elliot Lewis Center, presented her team’s research, “Is Steroid Premedication Necessary? Real-World Safety of Steroid-Free Ocrelizumab and Ublituximab Infusions.”

This study was conducted by The Elliot Lewis Center’s Dragonfly Research cohort, led by Joshua Katz, MD, and Andrew Bouley, MD, and assisted by research coordinators Isabelle Messina and Paola Castro Mendoza.

Research Goal and Methods

This retrospective study sought to assess the safety and tolerability of administering Ocrevus (ocrelizumab) or Briumvi (ublituximab) without corticosteroid premedication in patients with MS.

Researchers reviewed the medical records of 26 patients with MS who received ocrelizumab or ublituximab infusions without steroid premedication. Premedication was withheld due to factors such as insomnia, mood changes, irritability, anxiety, and hyperglycemia.

Safety After Eliminating Premedication

A total of 68 steroid-free infusions were completed. Only 1 patient resumed premedication due to headache.

Of the 26 patients who received ocrelizumab or ublituximab without premedication, 20 (77%) had no IRRs, and 6 (23%) had mild reactions such as itchy throat, itchy ears, and headaches.

Implications for Managed Care

When reviewing this data, Shackleton emphasized that this study was conducted in a clinical setting with an infusion center and on-site providers. The elimination of premedication was determined for patients who had already undergone introductory infusions of ocrelizumab or ublituximab.

The study showed that steroid premedication can be removed with little impact on patients. The majority of patients experienced no IRRs, and those with IRRs experienced minor side effects.

According to Shackleton, “Patient safety is our top priority. Understanding the safety and tolerability of infusions with varying premedications allows us to consider patient preferences, nursing time, and chair time. Adjustments in premedications for infusions are often considered; recent labels leave room for physician discretion. Our studies aim to provide data as a resource for prescribers making these decisions.”

Reference

Castro Mendoza PB, Messina IG, Bouley AJ, et al. Is steroid premedication necessary? Real-world safety of steroid-free ocrelizumab and ublituximab infusions. Poster presented at: National Infusion Center Association (NICA) 2026 Annual Conference; July 9-10, 2026; Las Vegas, NV.