Blood Tests for B-Cell Drugs (Ocrevus, Rituximab, Kesimpta, Briumvi)

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  • เผยแพร่เมื่อ 26 พ.ย. 2024

ความคิดเห็น • 83

  • @crystalvelasquez7594
    @crystalvelasquez7594 6 หลายเดือนก่อน +8

    This info is invaluable. Thank you for caring in a way that reaches those who may not have access to the type of support you offer. ❤

  • @garyrooksby
    @garyrooksby 6 หลายเดือนก่อน +9

    Fantastic video, Dr Beaber. I'm male 57, RRMS, diagnosed 1997. 13 years on Avonex interferon B weekly, 6 years on tecfidera and now on ocrelizumab (Ocrevus) since 2020. My hospital is tailoring the frequency of Ocrevus doses based on blood tests to lengthen the gap as much as possible while maintaining B lymphocyte suppression. It also allows me to have Covid-19, flu and shingles vaccinations once the B cells have recovered enough then 1 month for antibody production then next Ocrevus infusion. It's working well, monitored by periodic MRI scans and only one pseudo-relaps caused by major work stress (I've since retired). It's the best treatment I've ever seen.
    This video deals specifically with what's happening to me and what is being monitored closely so is absolutely fascinating! Thanks so much!

    • @DrBrandonBeaber
      @DrBrandonBeaber  6 หลายเดือนก่อน

      Thanks for sharing. How often are you having blood tests?

  • @jbell987
    @jbell987 6 หลายเดือนก่อน +4

    I’ve been on ocrelizumab since 2008 (Phase II study). After 10 years, many respiratory, ear and other infections. Then Shingles. Not so painful when you can’t feel stuff. Yea MS. Blood tests showed very low immunoglobulin levels. Went on IVIG (intravenous immunoglobulin G). No more infections, but went from 2 infusions/year to 14/year. IVIG is given 2 consecutive days each month plus the 2 Ocrevus infusions.

    • @josephvered3991
      @josephvered3991 6 หลายเดือนก่อน

      Hi from Israel very informative data thanks dear doctor

  • @andrewreisinger6860
    @andrewreisinger6860 6 หลายเดือนก่อน +8

    I've been on Ocrevus for about 4 years. No remarkable increase in infection. I'm a 53yo male edss 6.5.

  • @DanielSturgis-zi3sm
    @DanielSturgis-zi3sm หลายเดือนก่อน

    Yes. I DEFINITELY have a crap gap on Ocrevus for my MS. I get terrible, lower back pain and upper leg and glute pain starting about 4-5 months after I get my dose. Miraculously, it’s GONE within 12-24 hrs of taking the medicine. I’m concerned about fending off diseases as I age and its effects on the body protecting against cancer.

  • @TotalRookie_LV
    @TotalRookie_LV 6 หลายเดือนก่อน +9

    Currently on "Kesimpta" since last November, but it seems I've developed a secondary progressive MS, thus likely I'll be switched to another medication later this year.
    First injection was... impressive. I got no damage to eyes and brains are almost untouched, all damage is from neck down and some in the area where brain and spinal cord meet. So around 4-5 hours after injection my temperature went up, then hands, legs, abdominal and back muscles gave up. I still could drag my feet, but very slowly and had to hold to something to stay upright. Later I was laying on a coach, pretty much unable to even change my position, just felt extremely weak. Somewhere around 10-12 hours after injection those effects started to ease up. None of the following injections caused such dramatic impact, just the very first one. *So, if you are put on any of these drugs, DO NOT go to work as I did, take a day off and stay home!* The experience of being carried up a stairs like a piece of furniture by other people was not a pleasant one. I suspect other people may have issues with sight, speech, memory or whatever other nerves and brain regions they got damaged by MS. Now I'm sort of afraid of getting sick, since it seems high temperature caused by anything makes me go very weak.

    • @blackspider4
      @blackspider4 6 หลายเดือนก่อน +4

      Yup, just do the first Kesimpta injection on Friday evening. In my case I was down entire Saturday and back to normal by Monday. No downtime from work.

    • @TotalRookie_LV
      @TotalRookie_LV 6 หลายเดือนก่อน +2

      @@blackspider4
      My happened on Wednesday. I expected some trouble - I always get noticeably weaker the day after every flu shot or covid booster, I just did not expect my immune system to overreact to THAT degree.

    • @Julien.gauth6581
      @Julien.gauth6581 6 หลายเดือนก่อน

      Bonjour, je pense que ton neurologue n'as pas était "professionnel " sur la manière de prendre la 1ere injection ! Connaissant les effets mon neurologue m'a fait commencer un vendredi soir et il a bien fait 😅 il m'a fallu 2 jours pour récupérer ! Prenez soin de vous

  • @Julesnews-xb9cf
    @Julesnews-xb9cf 6 หลายเดือนก่อน +2

    Thanks for the video. Perfect timing for me. Diagnosed last summer. I started Ocrevus in Nov. I am going for my 6 months treatment soon and they will do blood tests prior to my infusion. Now, I am more educated on how to understand my results and what to look for when comparing with my baseline before Ocrevus. Thank you 🙏

    • @DrBrandonBeaber
      @DrBrandonBeaber  6 หลายเดือนก่อน

      Glad it helped. I know it can be very confusing to look at those labs

  • @user-im6qz6qv3j
    @user-im6qz6qv3j 6 หลายเดือนก่อน +3

    This is an outstanding video! I’m currently on Rituximab and always wondered what my neurologist is looking for in the blood tests before each infusion. Thank you!

    • @DrBrandonBeaber
      @DrBrandonBeaber  6 หลายเดือนก่อน

      glad it helped.

    • @AfreenKhan-du7bd
      @AfreenKhan-du7bd 2 หลายเดือนก่อน

      hello how are you doing in terms of general health after rituimab pls reply ?

  • @kathyoconnor5643
    @kathyoconnor5643 6 หลายเดือนก่อน +2

    Thank you for another informative video. I am on my fourth year of Rituxan, First year was every 6 months but after that went to 12 months due to low IGGs. I'm nervous as I go for bloodwork next week my IGG's get lower year.
    This is the first time I've been on a Bcell depleting drug and I feel great! I hoping I don't have to switch!!
    Would love for you to do a video about other DMTs that are as effective as Bcell depleting drugs.

  • @Nico-hd9bq
    @Nico-hd9bq 6 หลายเดือนก่อน +1

    Thanks for that great video! I'm really glad that my doctor is checkin all the blood levels every 3 months. So far i doing great with OFA since 1,5 years and have even less infections (probably due to a strict sport routine, young age and edss 0)

  • @nishk8774
    @nishk8774 6 หลายเดือนก่อน +2

    Why do significant numbers of patients who took ocrevus loose their mobility?

  • @EvenSoItIsWell
    @EvenSoItIsWell 6 หลายเดือนก่อน +2

    Thanks Dr. Beaber! I haven’t taken these drugs and wasn’t aware of all the blood tests and how the CD20 cells work.

    • @DrBrandonBeaber
      @DrBrandonBeaber  6 หลายเดือนก่อน +1

      The blood tests aren't as complicated as they seem. It's what to do with the results which is more controversial.

  • @MelissaFrank-h6w
    @MelissaFrank-h6w 2 หลายเดือนก่อน +1

    Hello Dr. Beaber, I am a 43 y/o diagnosed with MS at 30. Spent many years on Copaxone and just recently (Jan 2024) switched to Kesimpta. I have a strong FH of Breast CA (although I am BRCA negative) and dense breast tissue in which I receive alternating mammography and MRI every 6 mo. My biggest concern when switching to a B cell therapy med was (and still is) cancer risk. Are you aware of anything in the literature that would advise one to stay way from B cell therapy with an increased risk of Breast CA? Thank you in advance for your expertise!!

  • @donaldsmolder7152
    @donaldsmolder7152 6 หลายเดือนก่อน +8

    All of these doctors, including you keep saying talk to you on provider. My provider only has a total of five MS patients. 7000 patients total. He had heard of MS but that’s about it. He usually give you about 10 minutes of his time how you ask all this somebody that don’t even know about MS in 10 minutes dammit.

    • @blackspider4
      @blackspider4 6 หลายเดือนก่อน +1

      Is seeing a different neurologist an option?

  • @roberture5903
    @roberture5903 6 หลายเดือนก่อน +2

    Thanks for the video Dr Brandon, excellent information .

    • @DrBrandonBeaber
      @DrBrandonBeaber  6 หลายเดือนก่อน +1

      No problem. Glad it helped.

  • @PriteeShourie
    @PriteeShourie 6 หลายเดือนก่อน +1

    Thankyou Dr,very informative video for those who are on immunosuppresent drugs

  • @stonz42
    @stonz42 6 หลายเดือนก่อน +1

    Thanks Dr. Beaber, this info is very helpful to everyone on Ocrevus. I've been on Ocrevus since Sept 2022 and my doctor does all of those blood tests on me. I have seen my igM levels decline to below normal, but I haven't had any serious infections and remain on the standard 6 month interval. However, I did catch a cold a few days after my prior infusion and it seemed to linger for nearly a month. I suspect the Ocrevus circulating in my body made it harder for my immune system to fight back. Although my B cell count was 0 going into the infusion, so that may not be the case. My wife got it after me and kicked it in a week. I know everyone is different, but is there a time period range (years on Ocrevus) where most patients should extend time between doses or is it dependent on each individual's bloodwork (in that some never need to extend beyond standard dosing)?

  • @elizabethrash7370
    @elizabethrash7370 6 หลายเดือนก่อน +1

    Fantastic videos. Thank you! What labs would you do for mavenclad and is the risk related to this drug greater in an older population (without comorbidities) than a B cell depleter?

  • @Rachel-be9ty
    @Rachel-be9ty 6 หลายเดือนก่อน

    Great video! I always wonder what they measure in my blood when they take it during my infusions. Tried to look at it on my patient profile, but way too complex for the layperson lol. Very informative, thanks!

  • @thegoodolvet5586
    @thegoodolvet5586 6 หลายเดือนก่อน +3

    Wow! What a great video! Well put together on covering a wide range of topics.
    Thank you for all you do!

    • @DrBrandonBeaber
      @DrBrandonBeaber  6 หลายเดือนก่อน

      Thanks for the video suggestion.

  • @zoranagavrilovic9403
    @zoranagavrilovic9403 6 หลายเดือนก่อน

    Thank you Doctor, seeing this video posted reminded me that I have to do blood tests for Kesimpta until Tuesday x)

  • @roosholtzer9248
    @roosholtzer9248 6 หลายเดือนก่อน +2

    Thank you so much for sharing your knowledge! 🤩👋

  • @strivetounite
    @strivetounite 6 หลายเดือนก่อน

    It would be interesting/beneficial to see a comparison of pros/cons for RMS, comparing O, K, R, B. thank you.

  • @shahlaZafari
    @shahlaZafari 6 หลายเดือนก่อน

    Thank you for sharing this video. I would like to share my experience. in Jun 2023,last year I got very bad pains in my eyes and more in left one. I visited one neurologist and I had MRI brain with lesions. but he said because I do not have any other symptoms ,this is migraine. In November 2023 I started more symptoms in my left and right foot and weakness of my leg left. I had MRI from spinal cord and it was two lesions , one at c3 and another at T6. but they did not prescribed medication as they were not sure it is MS. In January 2024 I got influenzas and after that many other symptoms came up such as burning and sensation, no sense in my legs , after 4 months now they said I have active MS and progressive MS and I have to take cladribine treatment. I rejected this treatment and I spoke to them to start Kesmpta injection and I am waiting for their reply by next week. I am not under any medication and every night I have burning and pain in my both legs.
    Please advise me at this stage which treatment would be the best. Many Thanks

  • @Durace11Bunny
    @Durace11Bunny 6 หลายเดือนก่อน

    Hi, thank you for the video. Been on Ocrevus for 3 years. Had COVID x3 times, 3rd time left me with Atrial Fibrillation (heart arrhythmia). I had Pneumonia back in Feb. Otherwise doing fine EDSS 0 38 years wise lol.

  • @acvmomma7050
    @acvmomma7050 6 หลายเดือนก่อน +1

    Thanks for the video! I have two questions:
    1) what causes the reaction with Ocrevus… is it the mode of getting the med or the fact that it’s killing B cells? My question stems from those who switch from O to K or vice versa … if those patients already have depleted B cells, theoretically are they statistically less likely to have that reaction since they have less CD20 B cells since they’ve been on a similar drug?
    2) do you mind doing an in depth video like this on tysabri and the pill options that are similar to tysabri? I didn’t realize they worked similarly, and I would love to learn more! (The S word, sorry I cannot remember the word!)
    Thank you!

    • @DrBrandonBeaber
      @DrBrandonBeaber  6 หลายเดือนก่อน +1

      Of course it is possible to have an allergic reaction to any drug, but infusion reactions from ocrevus are usually due to depletion of b-cells and release of their proinflammatory cytokines. When b-cells are already depleted, the risk of an infusion reaction is less. Here is a video on tysabri: th-cam.com/video/LIKPYQFVNCQ/w-d-xo.html Here is a video on the biosimilar tyruko: th-cam.com/video/i6d-b6VTH5w/w-d-xo.html

  • @bemoniri
    @bemoniri 6 หลายเดือนก่อน

    Thanks, Brandon!

  • @npellet7487
    @npellet7487 6 หลายเดือนก่อน

    Thank you for this video! I’ve just started my 6th year of Rituxan. Last September, my doctor decided to do just one dose instead of the normal 2. In January my B-cells were still 0. I developed an Upper Respiratory Infection ( first infection in 6 years!). When my doc tested my B-cells again in February My CD19 B cells were normal and my CD20 B cells were high. This was the first time in 6 years the B cells were not zero. My doctor had me go back to 2 doses per round in March. I have experienced a lot of PIRA over the last year, I wonder if high Bcells could have contributed? I take Rituxan for both RA and MS.

  • @ahmeterwinog6295
    @ahmeterwinog6295 6 หลายเดือนก่อน

    Hi Dr. B
    Thanks for this great information. I take Ocrevus and when I got diagnosed with RRMS last October, my EDSS was 3. Now I am EDSS 1 after six months.
    I have a question: Is there a connection between mental psychiatric disorders and MS? I also have Asperger’s Syndrome (Autism level I).
    Thanks

  • @Elibangbang
    @Elibangbang 6 หลายเดือนก่อน

    Thank you for this great information, it's difficult to us, the patients to find these kind of information so well explained. I'm taking Ocrevus, doing so well in this drug, for me was a life changing to focus, memory and energy levels, even mood. I hope I can take this drug for long term.
    I have a "singular" condition, say by hematologist, maybe due the autoinmune condition itself: i have more than normal levels of IGM (500 mg/dl) even after the treatment, but, they said that I don't have to worry about, it's a little weird for me understand the cause...
    May I ask you a question? Do you concern about the simultaneous taking of ocrevus and isotretioin (acne treatment, in low level) by the effect on the liver the last may cause?
    Thank you for your divulgative labour

  • @luciece
    @luciece 6 หลายเดือนก่อน

    Thanks for this video! I'd like to ask, have you ever seen someone who had CD19 way below ref range prior 1st dose (no previous medication except high dose vit D /infections)?

  • @ernietollar407
    @ernietollar407 6 หลายเดือนก่อน +1

    is there any difference in the B cell depletion levels achived on rituxan vs Ocrevus?
    Is there any difference in how long it takes for them to repopulate on average?
    I su$pect not.

    • @DrBrandonBeaber
      @DrBrandonBeaber  6 หลายเดือนก่อน +2

      There may be a difference. From a review article on the topic: "Following rituximab administration in RA patients of either four weekly infusions of 375 mg/m2 or two 1,000 mg infusions two weeks apart, naïve B cells returned to baseline levels after 12-16 months" "Following ocrelizumab infusion, B cells returned to baseline or lower limits of normal in 90% of patients within 2.5 years of the last infusion. The median time for B cells to return to baseline was 72 weeks (range: 27-175 weeks) after the final infusion" Source: www.ncbi.nlm.nih.gov/pmc/articles/PMC9246073/ Whether or not this translates to differences in clinical efficacy is not necessarily known, but clearly they are very similar.

  • @HarmonicaPants
    @HarmonicaPants หลายเดือนก่อน

    Hello Sir, I have SPMS and I just had my 1st shot of Kesimpta the other day; soon after that I wondered what would happen (so being the {cheap 41 y.o. guy I am}) I asked 'Dr. Google' and was told that after the 1st shot the patient will have ~70+% of their B cells killed
    So then I wondered, 'why doesn't the doctor/clinic/hospital check the patient's levels before the 1st shot?
    Do you know?

    • @DrBrandonBeaber
      @DrBrandonBeaber  หลายเดือนก่อน

      I personally do check baseline b-cell counts prior to starting a b-cell depleting drug, but to be honest there is not a specific action I would take based on the exact result.

  • @hackett1181
    @hackett1181 6 หลายเดือนก่อน

    Excellent!

  • @davidflewitt1671
    @davidflewitt1671 6 หลายเดือนก่อน

    Hi could you maybe do a video about taking two medications such as tecfidera for psoriasis and ocrevus for MS, as when I was on tecfidera my psoriasis cleared up but when I had to change to ocrevus, my psoriasis returned with a vengeance all over my body, and because I developed new lesions whilst on tecfidera It was advised to change

    • @DrBrandonBeaber
      @DrBrandonBeaber  6 หลายเดือนก่อน

      There is limited data on this. The CombiRx trial (copaxone + avonex vs. only copaxone or only avonex) showed combining medications was not helpful. I am not aware of specific data on ocrevus and tecfidera.

  • @ernietollar407
    @ernietollar407 6 หลายเดือนก่อน +1

    when you say months after anti cd20 ur B's can come back exponentially I wonder is this not a kind of REBOUND? 9:00

    • @DrBrandonBeaber
      @DrBrandonBeaber  6 หลายเดือนก่อน +1

      They can "rebound" to levels slightly higher than baseline in some people, but unlike with some drugs such as gilenya and tysabri, this "rebound" is not associated with an increase in disease activity.

    • @ernietollar407
      @ernietollar407 6 หลายเดือนก่อน

      @@DrBrandonBeaber post hsct (7 months post Mexican hsct I am :
      similar, better and worse (sic).
      I am grateful for the work of Dr's like Beaber, Ruiz, Burt, Fedorenko and others yet, also, I am also of the opinion (or hunch really) that various truths, findings etc do overlap as per near infinite confounding factors. As they say 'god' (or Darwin's ghost) only knows .. I am looking forward to the next few years sans medical intervention to give my body a chance at self regulating. Although it has gone rogue on me with PPMS I have no doubt that it was an unintentional thing and that it still wants to help ME the organism. So far I've had the 1/2 doses of Ogrievous® and Cyclo-Ritux hsct. I'll give my ol sack of skin a chance without intervention, but simply, regular sleep exercise and happy days.

  • @dominicp134
    @dominicp134 6 หลายเดือนก่อน

    The current state is that the MS treatments in berlin germany hospitals are not happening reliably cause of "overload of patients" or the specific ms points were not reachable by phone. I think hospital ms point Neukölln has quitted collaboration cause they dont earn money with me. Berlin is saving money where they can. Brandenburg is not that extreme, but not where i live.

  • @hankmtproject
    @hankmtproject 6 หลายเดือนก่อน +1

    any thoughts on car T cell therapy for ms? considering entering a trial

    • @DrBrandonBeaber
      @DrBrandonBeaber  6 หลายเดือนก่อน +1

      I may do a video on this at some point

    • @hankmtproject
      @hankmtproject 6 หลายเดือนก่อน

      Ok cool. Could u give me a pov in the meantime? Kinda joking but also kinda hoping you’re like “do it” “it’ll be amazing”

  • @desiredecove5815
    @desiredecove5815 6 หลายเดือนก่อน

    Love the explanation Doc, thanks for the reference chart as well 🤘🏻
    #Sharingiscaring
    - as a overly cautious #MavencladMIlF I still mask 😷 up in public places or in a crowd.
    Sanitize like a mofo…( even wiping down public toilets 🚽 with Lysol wipes prior to layering with MASSIVE toilet paper 🧻)
    It helps cut down infection risk ( IMO)

  • @Mj-dc7lu
    @Mj-dc7lu 6 หลายเดือนก่อน

    Hello... Thank you for your efforts and interest regarding the treatment of ms , however, i suggest you make two types of videos ; one aimed to professionals and another aimed to those whom would probably start yawning 5 minutes into the video !! ....🌹👍

    • @DrBrandonBeaber
      @DrBrandonBeaber  6 หลายเดือนก่อน

      I don't think too many neurologists watch my videos.

  • @ernietollar407
    @ernietollar407 6 หลายเดือนก่อน

    listening on 0.75 speed

  • @ldjt6184
    @ldjt6184 6 หลายเดือนก่อน +1

    The B cell depleters are a bad choice - they make PIRA worse.

    • @DrBrandonBeaber
      @DrBrandonBeaber  6 หลายเดือนก่อน +4

      What makes you say that?

    • @fragariasec
      @fragariasec 6 หลายเดือนก่อน

      Isn't it the opposite? 😅 I just started Kesimpta with almost no symptoms and EDSS 0, so it triggers my anxiety.😂

    • @ldjt6184
      @ldjt6184 6 หลายเดือนก่อน

      @@fragariasec Were you always at EDSS 0?

    • @ldjt6184
      @ldjt6184 6 หลายเดือนก่อน

      @@fragariasec Well you're very young and at EDSS 0 so I wouldn't worry.

    • @hankmtproject
      @hankmtproject 6 หลายเดือนก่อน

      yeah why do u say that?