MS Drug Showdown: Which Medications are the Best?
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- เผยแพร่เมื่อ 22 ธ.ค. 2024
- Welcome to MS Drug Showdown: Which Medications are the Best? In this video, I'll be ranking and comparing the disease modifying therapies for multiple sclerosis.
Multiple sclerosis is a chronic, autoimmune disease that affects the central nervous system. It can cause a range of symptoms, including muscle weakness, difficulty with balance and coordination, and problems with vision. There is currently no cure for MS, but there are several medications that can help suppress inflammatory activity and slow disease progression.
In this video, I'll share my personal opinions ranking the MS medications based on efficacy to treat the disease. Whether you're living with multiple sclerosis or simply looking for more information on the available treatment options, this video is a must-watch. Stay tuned to see which medications come out on top in our MS drug showdown.
The Boster Center for Multiple Sclerosis accepts all major insurance carriers and accepts consults from around the globe, both in office and via telemedicine. www.BosterMS.com or call 614-304-3444 to schedule!
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COMMENT with your thoughts and questions below! MS Drug Showdown: Which Medications are the Best? What do you think are the Best MS Meds? Do you agree with me? I look forward to reading and responding!
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NOTE: Make sure to talk to your provider before ANY treatment decision. We hope to educate, empower and energize those impacted by Multiple Sclerosis. This channel consists of a collection of formal lectures and informal video clips about MS to help educate others. These videos do not provide medical advice and are for informational/educational purposes only. The videos are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen in any of our videos. They are just to help educate you about the condition guys!
Looking forward to your next video. It covers my main concerns/issues with these medications. Have tried everything so far on your list besides the top two. Fingers crossed one of those is tolerable by my body. Best wishes to anyone else with similar issues ❤
#StrongerTogether #WeHaveMS BosterMS.com
I have tried 2 so far, Tecfidera and Mavenclad and I’m still showing brain lesions. the side effects from Mavenclad have been extremely hard to deal with and I’m not sure I will go on with year 2. But I am definitely considering taking Ocrevus which I should have taken 2 years ago when my neurologist first mentioned that to me😢. Looking forward to better times for sure.
I've been on Ocrevus for over 5years now and I have only good things to say about this medicine. I tried Abagio, Kesimpta both failed for me but Ocrevus helps me manage better than anything else so far
Sir whether tablet Dyfira 240 which contains Composition
Dimethyl Fumarate 240mg good for MS?
Aubagio caused peripheral neuropathy of feet and increased my blood pressure despite on hypertensive medication for my hypertension. Had to stop it.
I was officially diagnosed in 2015 although I have had symptoms since the late 80s when I was a teen (i was ignored by docs for decades). I was first put on Copaxone and after 6 months, I was already in a flare up. I refused to continue. Then I took Tecfidera and the same thing. Then Aubagio, same thing. I threw up my hands and refused to take anything for awhile. Now I am on Kesimpta for the last year and a half. Finally, for the first time since diagnosis, no new lesions, I even have been able to stop using my cane. I did develop migraine headaches that I do attribute to the Kesimpta, but I take a med for that. I have had to stand up for myself with doctors and refuse to put meds in my body that clearly were not working. Sometimes I would swear the doctors were getting paid by the pharmaceutical companies. Its frustrating but I am glad we have someone like you to help us figure it all out. Ive learned more from your videos than any doctor I have ever seen.
Rebiff has been good for me, flu like stuff, that was it goes away,good luck I know how you feel docs sometimes forget we aren't numbers,we are people.
My wife went to Moscow 7 years ago for an auto transplant and has been disease free since that time. Following transplant she improved greatly on her performance status. We have almost forgotten that she ever had the dreaded disease. Good luck to those who watch this channel, we know what you’re going through.
Hi, what is a auto transplant?
@@joaniearc1186 The only thing I can think of is Autologous stem-cell transplantation
How does this work
@@joaniearc1186 it’s an autologous transplant. Her immune system behaved normally for the first 40 years of her life, then something changed and her immune system became auto reactive. In an auto transplant, a patients stem cells are collected and put in a bag. They then get high dose chemotherapy that kills the part of their immune system that is misbehaving. They then get their own stem cells back and their immune system reconstitutes with a rebooted immune system that is now auto tolerant again.
Can you please tell me more about auto transplant... Appreciate ❤
Been on Ocrevus for three years. For me it's been a wonder drug. I am truly grateful for it and my care team.
Agreed. Three years on Ocrevus as well. No relapses... two infusions a year. No complaints.
Agreed! Got my clinically definite diagnosis in late 2015, was put on copaxone for 5 years, then tried on tysabri (nope, my jcv levels are too high) so back on copaxone. Had 3 seizures one night in April 2021, was hospitalised for 27 days because of it and had IV prednisolone which made me feel normal!!! I also got a call from my MS nurse who told me to stop doing my copaxone on X date, because my neuro had enough evidence to get me on ocrevus!
I've been on it since July 2021 (couldn't do it in June because my wbc were too low due to the prednisolone) and it's been like I've gone back to who I was in 2019! I have to use patient transport to get to the infusions, and even the woman who took me for both starters AND the full one 6 months later, and she was amazed at how I didn't have to use my wheelchair anymore by that 3rd dose, just my stick! We both celebrated!
Did it help with your balance?
@@lottieew135 amazing, I'm glad you're getting a treatment your body responds to.
Why is it a wonder drug? Describe
Thank you, Dr. Boster! The side effects & safety of these meds terrify me ☹️
I am a 37 year old new grad RN. I was diagnosed in late 2020 and had been on Ponvory. I've had 5 relapses in that time, including my current relapse, which is now affecting my eye sight. My MRIs with contrast all showed no active lesions. It's interesting to see that Ponvory does not work as well with disability progression. I've been fighting my insurance for over 6 months to get Ocrevus or Kesimpta.
I'm so frustrated and terrified. It took me over 12 years to finally get my mental and physical health in order enough to get through college. I love being a RN, and I can not imagine myself doing anything else. It's what I was put here to do.
I'm scared that I won't have many years in my field before I'm forced out. I'm doing what I can with healthy living and just crossing my fingers. Sometimes, it seems like pure dumb luck where you end up with this disease.
Thank you for your videos, Dr.
Sending you so much love. We’re going to make it through this ❤️❤️❤️
Hi- Check out Along Kesimpta program for getting your medication. They have been a great support navigating all this. Do you have private insurance being an RN? If so, you need to maybe find a more aggressive minded neurologist..
I also diagnosed almost 1 year ago & put on Kesimpta immediately through this program. It's working... Best to you
Praying for you
hope ypu are doing better.. i was RN too
5 relapses is too much to stay on that drug. Your doctor needs to fight much harder and if they haven’t been able to get insurance approval yet then they are definitely doing something wrong. Are you being hospitalized during your relapses? Is there obvious worsening on MRI scans? My last relapse I was hospitalized and instantly approved to switch from Tecfidera to Ocrevus.
How about briumvi?
I took Lemtrada 5 day infusions in 2015 and 3 day in 2016. I have not been on any other DMD since and have not had a relapse, disease progression, or increased brain atrophy.
Previously on Betaseron and then Copaxone.
I’m glad I made the decision, I did a lot of research prior to taking Lemtrada, and for me it was the right decision.
I will say that I did develop hypothyroidism in 2019, and sensitive to environmental allergens but very minor.
For me, this was the right decision. I just did not want to be on a daily therapy for a multitude of reasons.
About 6 months ago I switched from Ocrevus to Kesimpta. I love Kesimpta. Never felt great on Ocrevus. I know everyone groups them the same but to me they were very different. Kesimpta and Tysabri both worked well for me with no side effects. I gave Lemtrada a try...did both rounds...I was devastated when I had new lesions after only 4 months both rounds...I ended up hospitalized 10 months after round 1. Lemtrada is the bottom of the list in my eyes...right there with gilenya and Copaxone.
I was on the study for both Fingolimod and Tecfidera after Rebif didn’t work. Neither slowed progression. I had 1 dose of Tysabri before the FDA black labeled it. Tried Retuxan back around 2008 and finally started Lemtrada in 2016. Unfortunately my last MRI (earlier this month) shows new activity. After 7 different treatments in 19 years I think I’m going to take a break. I’m sure everything I’ve been on has slowed progression to some degree but I’m just physically and emotionally worn out at this point.
Maybe you need those new ones( I forgot the name, but dr Boster talked about these not a long ago). Hopefully these will be approved soon as they look very promising
Tysabri - Natalizumab has been a game changer no new episodes since I started it 6 years ago. Still living with some nerve damage stuff that happened before I started it but the cognitive and speech problems I had are 95% better.
Thank you Dr Boster. You are invaluable to us in the MS community
The Doctor is truly a blessing to us on this Journey....
Thank you, Dr Boster for recording yet another fabulous video. When I talk with people who know I have MS, they always want to know more about my journey. I tell them the most important thing to do is find a personable neuroimmunologist who wants to do whatever you are willing to do. If you are willing to take some risk with highly efficacious medicines, then find a doctor who will support you......just like you do with your patients, Dr Boster. ❤
I send them to your TH-cam channel to watch your videos. So very thankful to have you helping MS patients and their families. 🔥🔥🔥
Tecfidera has been successful for me the past 3 years (I'm 60 w very mild ms issues). Can some dmt's like Tec or Aubagio be a good fit for older folks w mild or stable ms due to risks associated w the higher efficacy dmt's? Maybe you can do an updated video that covers aging & dmt's & some of the recent studies suggesting older people may be able to stop meds? I wonder what your list would look like for 60+? :) Pretty please?! Thank you again for all your time and energy to help educate, you're the best!
Same questions here 👍On Tec @ 52 seemingly stable ms 🧡
I was on Tecfidera for 4 years and became allergic to it.
i'm 61.. i worry about the side effects they haven't discovered yet!
Thanks for your rankings Dr. B. If anyone is looking for additional info on medication rankings, Dr. Brandon Beaber has a great video on his channel as well. The videos from Dr. Boster and Dr. Bieber have been super helpful for me since my diagnosis over 2 years ago. I'd be lost without them. Really appreciate all they both do on their channels.
I'm currently on Ocrevus and curious about the long term safety profile, say after 2, 5, 10 years. I have limited medical knowledge, but it seems that being unable to build active immunity to new pathogens can be problematic over the long haul. Can you please include your opinion on long term safety of b-cell therapies in the next video?
Dr Boster - I am happy to say that you prescribed Lemtrada to me in 2017-2018 . Aside from Thyroid issues post Lemtrada. My results have really been great. I am glad to hear that Lemtrada is still a first line choice after 5 years.
I have been using Copaxone for about 20 years and have not had any relapses. I will stick with this. : )
Soo great video for sure.
I am taking Tysabri monthly. I got an MRI scan completed after 1 year of taking Tysabri.
Result. My MRI scan was worse than my previous MRI scan. During the previous MRI scan. I was going through a relapse with vertigo. Yet the most recent MRI scan was worse than 1 year taking Tysabri.
I have got Active Leisions currently. They want me to take Lemtrada. Moving forward, they stated I should get HSCT (Stem Cell).
Personally. I don't want to take either...
I was thinking that Tysabri is on the same level as Ocrevus. What a surprise!
Very clear outline Aaron, thanks for making these videos for all of us MS patient's. It's such a confusing journey at times but this helped to clear up some questions I've had. Thank you again 😊
Thank you! #StrongerTogether #WeHaveMS BosterMS.com
@@AaronBosterMDis it ok to start the medicine only after 1 episode with no history?
Thank you. I totally agree, your videos really helped inspire me to persue Lemtrada. I'm very happy with it. I prefer the best possible option when it exists, but before Lemtrada nothing was ever really good enough in my opinion. The potential benefits were very substantial though actually accessing the drug was a challenge. Of course there's relatively high risks, even now, but it was almost free and I tollerated it very well. I'm hoping it has a virtually curative effect without any more doses. It's one of the only drugs with a true potential lasting "remission" of MS with NEDA without additional use. So far 3 months. I'm hoping for at least 8 years to life lol. Hopefully it killed all the offending cell lines and I lack the continued propensity to develop more offending cells with greater regulatory cell lines.
Dr Boster: where would we be without YOU? Analysis is so informative & much appreciated.
I echo your thoughts.
Diagnosed in 2020
Put on rebiff 44
Slight improvement
Thank you for doing this video. I just contracted MS and you've been so helpful in my journey towards regaining my health as best I can.
Kevin S Gallagher
Gday mate. Love your work. I’ve just been diagnosed with MS. Long story short 7 months ago, after recovering from covid, half my body went numb then I lost all feeling in my foot. They did an mri and found 3 lesions, one was so big they thought it was a brain tumour. Anyway, after 2 weeks on prednisone I was released from hospital and I recover back to 100% probably like 2 weeks after that. Did a follow up mri after 3 and 6 months. After 3m nothing new, after 6m they found another one on my brain (4 in total, none on spine) then diagnosed me with Ms and told me to pick a DMT. She gave me 3 choices. Zeposia, fingolimod and vumerity. I’m tossing up which one I should take if I even do take one because knock wood I feel fine. Would appreciate some advice. Thanks Aaron.
My mom has been on Rebif for 15 years and it has worked really well for her. She does have a couple slight brain lesions but MRIs haven’t changed through the years and currently has no symptoms. She hates injecting herself 3x/week but trying to figure out if she should stay on the meds, switch meds, or get off the meds (per doctor recommendation). Appreciate all the insights you give in your videos!
Ive been using rebif 44 for 6 years and I am currently switching to Ponvory. I am a little nervous about it, you know, 6 years is a long time. Rebif works for me and kept me stabilised. But I am fed up of the injections and the reactions after. So the idea of taking a pill once a day seems very comfortable for me.
Unfortunately Lemtrada has stopped being effective for me. I've had three doses and continued to lose feeling in my feet and hands. My doctor wanted to put me on Tecfidera or Ponvory, I'd prefer to be on Ocrevus or Kisempta as they are higer efficacy and seem more convenient. I'm only 35 and think it's best to be as proactive with treatment as possible.
Your videos are the best and we so much need your guidance. I am sooo grateful for your videos and your time educating us. I have an opinion now because I feel educated since watching your channel. Amazing thank you so so much ❤
I just switched from Tecfidera to Vumerity (because it seems nicer on the stomach and I'd like to not depend on meals to take my twice daily meds).
I had looked into mavenclad and ocrevus as well, but my clinical profile seems too stable for me to qualify for stronger treatments.
I've only had a mild attack in 2015 (weird pins and needles in one hand and one side of the face, nothing else), got diagnosed in 2017 by accident, been on the interferons shortly but I was allergic, on Tecfidera since then and a part I think 2 tiny MRI spots I had nothing.
My MS has been boring and I am very glad about it. I wonder though if it was safer to be on better drugs? But it really depends if a patient "qualifies" for them, at least in my country.
I have a question, when I was diagnosed with MS in 1997, I would initially had flair after flair. At that time I lived in Buffalo NY. My neurologist at the time, would give me what he referred to as "steroid booster" every 3 months -3 days in order to ward off flairs. It did help. I was fortunate to be able to work as a financial advisor for 18yrs with little progression. But now I am secondary progressive MS. I struggle everyday. What are your thoughts on this practice. It seems to reason if steroids controls inflammation, isn't there some way to PREVENT the symptoms, not just infuse when they present.
Side note-in 1997 I was also taking Betaseron.
Thanks for your work. You are truly helping people.
Mary Lamb
Thanks for the video. This is always the ultimate question - what is “best.” The side effect lists are so scary to people - I get it. I wish someone would create a “side effect list” for delaying DMT or not even starting. The list of untreated MS compared to the POSSIBLE side effects of DMTs would make the choice clearer.
I also wish there was more transparency about actual outcomes/side effects. For example how many people taking tysabri actually get PML? People believe it is much more prevalent than it is - but how would they know? Thanks again.
Thank you for the video on efficacy. Doug coffee in hand from Lyndhurst Ohio.
Always great to hear from you Doug, I look for you in the comments section every week. Robert from Syracuse with decaf coffee in hand
Taking the supplement mushroom lions, mane for lesions helps heal almost all of the lesions everywhere. have had the experience of seeing damaged white spots on my brain and spine on an MRI but now they were all gone after six or more months.
HUH? where’s Briumvi????
I would love to hear your view on the new remyelination clinical trial happening in California
YES me too! Such exciting news😎
I have been on infusion therapy for 3 years with Rituximaub and have never had a relapse or a side effect from the drug..
Briumvi seems to be the superior treatment for many patients, maybe time for a new video?
Been using Avonex since 2011 and it's working fine, no relapses at all.
Thanks Dr B! Another great video. I hope for the best for all our MS warriors 🙏
Thank you for sharing this. I'm torn on meds because variables... I feel pretty good on my med it's easy to take pill and I never miss it, and my cognitive ability/capacity has even gotten better, but from your comments, it's not as good as others for slowing disease progression.
Curious to know which you're taking... best wishes.
Surely it depends on the patient. If your MRIs are good i don't see the problem. I was diagnosed 7 years ago, got treated with lemtrada. Had a third dose a couple of years ago but it hasn't worked aa well for me as hoped. I'm switching to tecfidera now. Will see how it goes
Copaxone, Tecfidera,Gilenya and now coming into my 14th yr diagnosed Ocrevus.
Great info. Diagnosed in 1995. Taken betaseron, copaxon, tysabri, aubagio. No medication for over 3 years now......
I need to get a new neurologist, and MRI...
I LOVE UR VIDEOS
HOWDY 😂😂😂
I learn alot from ur video's
I like how u use the words EFFICACY on the different kinds of DMT'S. I wish i was a patient of urs. I believe i would walk out of ur clinic, happier than i do with my neurologist now. Wow seeing that our health care system has really suffered alot over these past couple of years. Prime example..friend still waiting on a hernia operation , was told it could be up to a year, from when first saw dr in Nov 2022.
At least ur videos give me some hope with MS, as showing ur smile, and ur kind words, & ur jokes, keep me always feeling grateful, that i have u to look up to. Ur videos like i said, lift up my mood. Have a great day and thanks for the inspiration.
Question: i was wondering if u can do a video on 'accepting ur MS, because some people can't accept it. When people say MS has me , its true when it has affected u physically. Sometimes we need a reality check, that this is real & to accept it.
Hi Dr. Boster. Thank you very much for your helpful video. My wife has diagnosed with MS the past month and she is trying to decide between Ocrevus/Kesimpta and Mavenclad. She is 30 years old and her symptom was Optic neuritis (Her neurologist called her situation mild). We are gonna have family in the next few years but the priority is to be safe and take the best med for her disease. She is a very active person also. Her Doctor proposed Mavenclad since it is easier to have family but her concern is the "good" efficacy of the med over "high" efficacy of the Ocrevus.
Hi Aaron I'm glad I saw this as I was given a choice. I chose alumtuzamab and have a reduced disability of around 60% my name is James from Australia and am glad to offer my advice 😀 I'm under professor Simon broadly, gold coast university hospital qld. Australia
I started watching your videos in February this year. This morning I had my first Rituximab infusion, which was my first DMT since I tried Avonex for only a year, 15 yrs ago. Thank you, Dr Boster for leading me back to the track. I was scared but not anymore.
I'm on Ocrevus 3 years. My edss before it was 3.5, now it's 6.5.
Kesimpta is what I take and have done quite well so far. Have an MRI coming up! Also, thank you so much for your thoroughly informative videos!
Great video doctor. I wanted to ask your opinion on some of the new myelin repair clinical trials that are happening. 3 years ago it was said that by 2025 we probably would have a myelin repair treatment. Do you think thats possible?
Thank you so much - for educating us.......I truly needed to hear your information.....I appreciate you bringing this to us. It is so great to see you DO read our comments, and you DO take time to help us - I have so needed this....
I started with Rebif but my body developed antibodies making the drug useless. Then I switched to Copaxone and it worked great. The daily injections were no fun and I developed skin issues. Then, I was on Tecfidera but the side affects were too much. Then, there was Aubagio, and years of being relapse-free ended under Aubagio. Then, I switched to Gilenya and it has worked great. I'm currently on its generic version.
Have been diagnosed the last week and given options of ocrevis and kesimta injection.. I don't know nothing about any of them really buy have been told to do research, I'm just trying to look and people's opinions on what worked best for them, I have to make a decision
Thank you for the info. How about Briumvi?
I haven't been on anything for my MS in 5 years. My reasoning for not taking anything are side effects, bad reactions and fear of something fatal. I have really bad depression and it's hard enough living on top of taking MS medications that have such bad side effects that make life even harder for me. I just dont feel strong enough mentally to take on a new medicine. I did copaxone for 9 yrs before I had a random reaction that sent me to the ER. Then I tried Avonex but 3 out of 7 days I'm literally in bed just trying to recover from the medicine. Nothing seems worth what little happiness I have. Which isn't much. So i just dont know what to do.
I pray you find something to work
I hear you. I am feeling the same way. If the cure is worse than the disease, I don't want it.
Wow! Dx at 62, late-onset PP, and first and only DMT tried was Copaxone. 3rd injection resulted in such violent rejection as to never again attempt but do weekly Adaptive Yoga for MS session, repeated as needed (PRN), and so far, MRI stable for 5 yrs.
Tolerance of MS easier than tolerating the DMT! Your video exceptionally frank and explanatory: look forward to one on tolerance.
I’ve been on Tecfidera for just over a year (240mg) haven’t had a relapse yet/no MRI progression. My last relapse was in summer 2021 when I wasn’t diagnosed. It’s working fine now, some flushes but that’s all. If I get more lesions I’ll probably change my medication to something more effective.
Trying to get approved to start Briumvi soon. Do you have thoughts on that, or is it too soon? Seems very similar to Ocrevus but but with shorter infusion times. Curious if you would put it as the same ranking as Ocrevus?
Hi Dr. Boster, I’ve recently been diagnosed with MS and still learning lots about the disease. Thank you for sharing this information as I will be asking my neurologist about these medications. I also intend to sign up for future clinical trials of new treatments for MS specifically intended for endurance athletes, ie. cyclists, runners and swimmers. These are just some of the sports that I’ve done for most of my adult life. Thank you again 🙏
Hey doc, new subscriber. My wife whos only 34 years old was just diagnosed over the weekend. What is YOUR recommendation for what you feel is the best treatmeant?
Dr B- thank you for all your info! I’ve learned more from you than my neuro in the last 6 mo. I’m on Ocrevus. 2nd 1/2 tomorrow. But I also have active tick borne infections. I want to treat, but the Ocrevus suppresses. I realize immunomodulars would be best, but could you give your opinion on “next best”. I’ve got new symptoms since O.
Just had my fourth dose of Ocrevus and ended up with pretty major side effects which I haven't had before (two weeks of really intense and localised headaches on the left side of my head). I also noticed that once that finally had past that ANY physical activity was DRAMATICALLY harder and I felt like I had run a marathon afterwards, while a week before my infusion I did the exact same exercises with no issues afterwards.
Looking to change to something new, my neurologist has suggested something which is similar to Ocrevus but you self administer via injection once a month. I can't recall the name and he said he would discuss it with me closer to the date when I could change (over five months from now), he also isn't a fan of interferons so I'm guessing it won't be them (I'm also JC positive so that cuts out a bunch).
It’s probably kesimpta
Thanks for your input - I changed from Tysabri to Ocrevus a year ago and it’s been much better for me. I haven’t seen any improvement in my physical ability but my walking is still steady, no changes to my MRI. I don’t have JC so I hope I won’t get the side effects you describe.
Sorry to hear that. For me Ocrevus has been a miracle drug with no detectable side effects.
Can you link the video you mentioned at the end? This was helpful thanks!
Can you elaborate a bit on the Mavenclad ranking? I know it has great efficacy for halting new lesions, but what do you consider the downsides? Also if you have patients who have used Mavenclad and it stopped progression (my treatment has), do you suggest further DMTs?
Excellent video as always, Dr. Boster. What is your take on the newcomer, Briumvi?
Howdy Dr Boster a very informative video so easy to understand until next time take care from England Derby 👍
🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥THANK YOU DR. B!!! You are an AWESOME human. I truly appreciate all of the time and effort you put into these videos and have learned so much from them. 🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥❤️
You are so welcome
Rebiff has kept me from getting too bad ,was wondering why you don't like it, other drugs have bad side-effects, I think. 20 yrs and only 2 new plaques.
What's the rank ordering for meds to treat CIS? Not all are approved.
I am 55. I am on Ocrevus. It’s been suggested to me to stop Ocrevus because of my age and switch to something like #4 on the list. As far as I know all my MRI’s are stable. Does age play apart in choosing a medicine? Do you recommend older patients not take Ocrevus because of age?
Thank you for a very interesting talk about the different medications for MS.
Your information is always amazing and outstanding and very clear precise to the point thank you very much Dr.
You are very welcome
I'm currently on twice a year ocrevus and twice a day ampyra pill but that still doesn't do its job. I feel the pressure in my brain 😫
Thank you for explaining why you ranked these as you did!
Oh wow, I didn't expect you to rank Tecfidera so low. 😳 I think of it as my little miracle. I've had no relapses since starting it 3 years ago, no mention of brain volume loss, no side effects, perfect bloods across the board and energy to go to the gym regularly. I wonder what the catch is. 😂
Really happy it’s working for you. Made me sick to the stomach, hives, flushing that didn’t go away with time BUT everyone is different so definitely stick with what’s working for you❤️
To be honest I am doing pretty good with Rebif 44 too. I use it for 6 years now and so far so good. Only negative is that I am anxious a little more(but I was before ms too, so…) and after those years my skin is kinda tired of those injections all the time (but still much better than copaxone in that matter)
Tecfidera is the only drug available in Canada for SPMS….at least according to my neurologist. Was on it for a number of years and was talked into going off it. Now on nothing.
Same here 🧡
2024 update: Tecfidera stopped working after 3.5 years and I'm switching to Kesimpta. Bummer! I really liked Tecfidera. The first thing I thought of when I was told was Dr Boster's comment that it's best to start with the most effective/aggressive therapy available, so figured I'd drop an FYI for anyone interested. I still didn't go for Ocrevus though 🤮lol
Good Morning.
How do you chose which drug is right for the patient? Why not use the most effective drug for all patients?
Thank you for all your help.
🔥🔥🌄🔥🔥
Where would you place Briumvi? Kesimpta was working really well then freak crushed my entire WBC count so was switched to Briumvi
Had my follow-up today with my neuro clinic and was asked if I was interested in switching from Ocrevus to Briumvri...had never heard of this drug which apparently just got FDA approval in December of 22. Have you discussed this drug in any videos? My neuro team indicates it is basically Ocrevus but maybe a little less side effects...
Thank you for your information, really useful.👍
Thanks for this!
I have SPMS, & am on retoxen, For the Past 5 plus years. I've heard some News about Mayzant & lessening symptoms. Thoughts
Thank you so much 💫
I know these are your opinions - but I read so much about people who needed a 3rd, 4th dose of Lemtrada or who have to switch to other high efficacy DMT’s… so what makes it better than O, K or Rituxan?
Brooke, I had very active RRMS (failed on 3 drugs) when I was infused with alemtuzumab in 2010 and 2011 (I used it off label as it was not approved for MS at that time). While alemtuzumab worked by stopping progression, I continued to have unwanted MS activity and received 2 additional infusions in 2013 and 2015.
Remember, the drug is approved to be administered in two sequential years, so 2 infusions equal 1 treatment. So, the decision to do another course of therapy meant another 2 infusions. This means I had a total of 4 infusions or 2 treatments.
can't
For disclosure, I am current patient of Dr Boster's. I was diagnosed with MS 30 years ago in 1993.
Sadly, none of these drugs seem to work.. the side effects that people talk about are horrible!! Is it even the meds that they claim to work.. or luck? MS has been around forever, not sure why they cant come up with a cure!! So many people suffering!! Sadly!! Good luck all!! My opinion!!
Wow 🤩 again a great video in this series- I like how you explained, HOW you choose the meds that you suggest to your patients and why.
It’s always a reinforcement that I have the BEST neurologist on the planet & keeps me up on my MS Nursing.
Thank you again.
#Sharingiscaring
#MavencladMILF
Thanks for the video this was helpful to me to get your 2023 opinion.
Rebif sucked for me didn't do a thing I kept relapsing. I liked tecfidera until I had to go to the higher dose it made me sick. I do good on most medications until it moves to the highest dose and then it's all she wrote I'm sick.
What are your thoughts on Bafiertam and where would it fall in your list? Thanks!
Hi, Dr. Boster.
Thank you so much for your insights. I've recently been let go from an MS medication trial due to an allergy with the iv-contrast that is used for the trial. I'm looking into Ocrevus and Tysabri since watching your videos.
Best wishes to you!
Thank you for the information
What about side effects? Talk about that please
This is fantastic thank you Aaron!
What about pain relief medication. What happens when your pain is uncontrollable. When you suffer pain 24/7 365 days a year central nervous system pain. What new help is there
Thank you for another great video Dr. Boster! I'd like to know, when someone fails Ocrevus, what's the next step? Is it always Lemtrada (as the only confirmed "update" in terms of efficacy) or would you consider switching to Tysabri (considering efficacy is comparable but has rather different mechanism of action) or maybe Mavenclad. Is Ocrevus -> Tysabri switch even safe (not sure about JCV test raliability coming from anti CD-20).
For me, my next step was to step back to Tecfidera.
However, my Ocrevus failure was because of allergic reactions during infusions.
No relapses, new or enhanced lesions, but I've progressed to using a cane due to balance issues and recently worsening left side weakness.
I am now on Kesimpta (4 months) and have had no negative side effects other than some fatigue. Fingers crossed that my worsening symptoms stop.
I did not see HSCT on the list, do you believe it is not effective for MS?
Does modafinil is not effective in MS?
Hello Dr Boster I get slot if info from your videos I have to ask my wife has been in ocervous for 4 years now and no great results! She has spinal issues and herniated disk has this something with MS or because if her health and lack of movement cause her weight gain. And with that said why hasn’t her dr given her some weight loss treatment to help her with her back pain and weight gain how can We voveirnce them this will help her and don’t think I’m wrong I’d appreciate response I respect your opinion!✌️😊
I was diagnosed 14 years ago. Treatment are more effective than 14 years ago. We know more about MS than ever before. Yet our newer and better treatments make our lifespans way shorter than the older treatments. I’m guessing I’m asking for too much to have an effective treatment that doesn’t carry a higher risks of death than cigarettes alone.
where do you get the information that newer treatments shorten lifespans?
I’m confused. I take an infusion medication called Ocrevus.
this is a great video. honestly, where I'm at is confounding. i currently have no disability, but I do have 3 lesions on my spinal cord but no evidence of demyelination in the brain. So what do i do? Aubagio has been recommended but if one day my MS causes disability why not go for something more efficacious right of the hop? I know many in the MS community are wrestling with that. Ultimately it'll be the tradeoff between efficacy and risk so I'm really looking forward to your next video. I look at something like Mavenclad and if a quite fit (I work out daily and eat an anti-inflammatory diet) non smoking guy in his early 50's with no discernable disability is seen as low-ish risk for an side effect I'd go with it. The thought of its dosing schedule is appealing.
They usually start from the bottom of the list and gradually upgrade the meds… I am 33 and I do self injections for almost 8 years and I would love to stop and try something less annoying. But I dont know yet.
Where is the research our lifespans are lesser now with DMT drugs?
Can I ask why is interferon a treatment at all? If MS is an autoimmune disease, wouldn't interferon exacerbate it?
I'm on teciferda