I am on Ocrevus, and it is a blessing to be on it. I have RRMS, and I just recently received my 3rd Infusion. THANK GOD, I haven't experienced many side effects at all. I work very hard on taking care of my body, PRAYER GOES A LONG WAY for Me. The headaches I experience, I've been placed on an Injection (once per month, every 28 days) which works incredibly well. I've been extremely lucky to be connected to my Doctor at Yale Medicine.
I’m so grateful to you and Dr. Aaron Boster for creating your channels for MS patients like myself 🙂I’m curious to know- when you say Ocrevus is for relapsing forms of MS- what do you mean by relapsing forms ?
The is just part of the label from regulatory agencies (FDA, EMA). Relapsing forms of MS are forms of MS where distinctive relapses/flares/exacerbations/attacks occur (for instance in relapsing remitting multiple sclerosis). Ocrevus is also approved for primary progressive multiple sclerosis based on the results of the ORATORIO trial.
I am - hopefully - starting Ocrevus soon once the pre-tests have been completed. Thank you for this vid, it is much appreciated and adds to the other info I have been getting about this med. Regards, John from New Zealand.
Your videos are super helpful and make it very clear to understand. I often get lost in all the reports and trying to pull the info im looking for, but your straight to the point on topics and easy to understand. Thanks for what your doing!
@@DrBrandonBeaberI liked it for this video for sure. I wouldn't jump out and say it would be best for all your videos, as I think we have all been through a death by power point in our life. I think a healthy mix of power point back to your video feed depending on your topic would be great!
It really works and helped with my MS, however....more education and research needs to be done in regards to increased risk of cancer. I developed triple negative breast cancer after my 3rd Ocrevus infusion.
Please explain I’ve put off doing this treatment because of unknown cancer risk. Would you say it helped or hurt or was it worth it in the end? God bless n thanks
Thank you so much for your incredible videos! I’m 57. Am I too old to start taking Ocrevus? I’ve been on Plegridy for nearly 4 years and my neurologist suggested the switch.
I had this treatment a couple months ago. I now can’t taste my coffee. I won’t do this treatment again. 20 year MS patient. Never conventional treated before. I am going to try the Tao Patch. Thanks for your videos, Dr.
Do you think that this drug will lead to cancer in the future? That’s the only thing i worry about, mind you I still take it despite any risk because I don’t want anymore irreversible neurological damage. Just wondering where we stand now that the drug has been out for awhile.
Question: If I go on Ocrevus (let's say December 2022),, but then have a chance to recieve HSCT about a year or so later, would there need to be a space of days/onths/years time after Ocrevus and before receiving HSCT ? Thanks for all these videos Dr. B, they are so clear concise but carefully detailed for the every person to learn from and ponder options in a balanced way. So, so grateful we all are!
If immunoglobulin levels go down, is it possible to stop the infusions until they go back up again? And also, after couple of years of taking Ocrevus, can the infusions be given less frequently? Is it ever gonna be possible to stop taking it, like with Lemtrada when new, maybe better cells grow back? Thank you!
This was a very good video. So can you tell me if someone on Ocrevus is able to make any antibodies at all when exposed to a pathogen? Im thinking most of Covid right now. Thanks!
Thank you so much for explaining! Actually, I had an opportunity to make the change to Ocrevus last year, but stayed on dimethylfumarate for another year, bc I was afraid of PML, and now you're saying the risk is actually lower on Ocrevus.
I'm on ocrevus since 2018 and have the jc virus... Took me 2+ years to kinda accept it. 2019 my younger brother get diagnosed with ms and just yesterday my uncle who was 33 passed away from pml..... Talk about a living nightmare 😢
@@martinis_mission8895 hello i just came across ur comment. I was diagnosed last year with rrms progressing type but chose not to b on dmts same reason as u . Im not willing to risk cancer and pml risks. I would rather have walking difficulties than cancer or permanent paralysis
@@joshualopez8309 hello joshua jyst came across ur comment. Ive commented on the previous comment too. I hope ur doing well and im sorry for ur loss. I hope u dont mind me asking did u get jc positive from ocrevus? And what did the drs say they wud do about it? Im personally not on dmts. Im not willing to take the risk of the side effects. I cant handle 2 diseases. Drs refuse treatng my relapses only because im against dmt. Its just a personal choice.
Thanks for the video. Have you heard of any side effects that include extreme thirst and urination, feelings of blood sugar fluctuations, intermittent cold limbs and lethargy and dry eyes - all decreasing gradually over about 10 days? I've taken Ocrevus since 2017, but the last 4 doses have given me these strange symptoms about 24-48 hours after (perhaps as the steroid wears off). My current hypothesis is something to do with the steroid spiking my blood sugar and my body taking it's time to regulate it (in fact the first time it happened seemed triggered by eating sugary cookies the day after the infusion). The previous years on Ocrevus were absolutely fine. Thanks again.
I'm afraid not. I was told to just change my medication. I start kesimpta in a week. Sorry to hear you have strange after effects. I hope it doesn't persist.
It seemed neither my neurologist nor infusion nurses wanted to understand why I had the symptoms so decided on the easy option of switching to kesimpta. If your symptoms are related to mine then my hypothesis of it being the steroid is defunct.
@@philth123 good luck on kesimpta ! I still haven’t decided what to do about switching to twice a year with O or staying w K. My ins debacle finally alleviated so now it’s just up to me. Praying about it !! I hear ppl have gnarly reactions to O and I’m trying to sort how why that’s (like what it’s caused by) and if I’ll have the same issue since I’m already in a B cell killer. So much to weigh out !! Good luck my friend !!
Definitely enjoyed learning more about Ocrevus! I've been on Copaxone (Glatiramer Acetate) for about 5 years now since my MS diagnosis. I had an MRI recently and my neurologist found that I have a new and recent neck lesion. What is a neck lesion? I have been symptom and relapse free of MS ever since I was diagnosed while on Copaxone.
You may want to talk to your own provider, but they are probably referring to a lesion in the cervical spine (the part of the spinal cord which travels through the neck)..
I talk a little bit about a potentially increased risk of breast cancer with ocrevus at around 11:20 in this video: th-cam.com/video/BVhN4_sEi1s/w-d-xo.html
Happy Hump Day! I don't know how folks with rrms are doing on ocrevus, however, it seems a lot who have ppms and are on it are still progressing as if they didn't take it.
Ocrevus is much more effective for RRMS than for PPMS. The data from the OPERA I and OPERA II trials (Ocrevus vs. Rebif in RRMS) are very encouraging, and experience in the real wold reflects this: www.nejm.org/doi/full/10.1056/NEJMoa1601277 In progressive MS, the results are more hit-and-miss as has been the experience with rituximab. The results from the ORATORIO trial (Ocrevus in primary progressive MS) are far less impressive, but it was still a positive trial with statistically significant results: www.nejm.org/doi/full/10.1056/NEJMoa1606468 The reality is that Ocrevus only decreased the probability of progression on the average, and many people in the trial progressed. Also, the inclusion criteria of the trial attempted to select people who were most likely to benefit from the medication.
Thankyou so much for bring there for MS patients like me with PPMS, who have not been given any answers or hope by her doctors. I would like to ask you, I have a choice between Rituxan & Ocrevus....which one should I ideally take for my condition. What would be your advice?
Thank u doctor for your videos... I have a question regarding side effects... I've only started ocrevus in december 2020 ... And i want to ask if extremity swelling could be a side effect of ocrevus or not.. thank u..
@@gabes738 When b-cell depleters such as rituximab have been used to treat lymphoma, very severe infusion reactions involving heart problems have been reported, but as far as I know, this has not been an issue with Ocrevus, rituximab, or Kesimpta in MS. Steroids given to prevent infusion reactions can temporarily cause high blood pressure.
Complete blood count, urinalysis, lymphocyte subsets, liver function tests, immunoglobins G, A, M. I would only do hepatitis screening and varicella antibody screening once unless someone is high risk.
Hello, thank you for this information. Can you stay on Ocrevus even after getting serum sickness like symptoms? (Joint pain) And how long do those symptoms tend to last? I really like how ocrevus has stabilized my MS and would hate to stop it
I was getting a histamine release on the second day after. I am not sure why but it has made my neurologist to change my medication. Also I have small veins.
Hello Dr. Beaber, my son is set to begin treatment on Ocrevus very soon, but only just now did we think to check see if there's a drug interaction with his Probiotic mix that he has been taking. At least 5 strains are listed for their moderate conflict. Should we flush his system of these bacteria? The strains in question specifically were : Bifidobacterium infantis [Bifidobacterium longum subsp. infantis (UABI-13) 0.9+ CFU] , lactobacillus acidophilus [DDS-1] , lactobacillus reuteri [UALre-16] , lactobacillus rhamnosus [UALr-06] , lactobacillus rhamnosus [UALr-18]. Should we delay starting Ocrevus infusion until we're sure these bacteria are purged/all gone? How should we do for safety here to remove these bacteria? I couldn’t thank you enough for your time Doctor and any help you can give would be is so valuable. He was suspected to be at the stage of SPMS [in case that is of any bearing on this consideration]. Thank you.
I can't give you personal advice here. This is the second on the product label with respects to drug interactions, and it does not mention any probiotics: "7 DRUG INTERACTIONS 7.1 Immunosuppressive or Immune-Modulating Therapies The concomitant use of OCREVUS and other immune-modulating or immunosuppressive therapies, including immunosuppressant doses of corticosteroids, is expected to increase the risk of immunosuppression. Consider the risk of additive immune system effects when coadministering immunosuppressive therapies with OCREVUS. When switching from drugs with prolonged immune effects, such as daclizumab, fingolimod, natalizumab, teriflunomide, or mitoxantrone, consider the duration and mode of action of these drugs because of additive immunosuppressive effects when initiating OCREVUS [see Warnings and Precautions (5.2)]. " www.accessdata.fda.gov/drugsatfda_docs/label/2017/761053lbl.pdf
Hello Doctor : So My girl friend was diagnosed with RRMS 6 years ago, she just had her newest MRI last week and found only 5 new lessions on her spine they found nothing new in the brain , Her neurologist suggested to start "Ocrevus" to slow the progression, she is 22 . It makes sence, but i feel its to early to think of medication. "We are on the fence" with this . can you give us some input on this. Thanks........ Great Channel !
You talk about reactivation of previous exposures with Hepatitis. I was wondering if there’s been any link to reactivation of HPV? I dated someone who tested positive for the HPV 16 strain and I possibly carry it. I know there’s some cancer risk associated with that strain and just wanted to check as Ocrevus is a treatment I’m considering.
I am not aware of any specific data on this topic. One article I found speculates that HPV/cervical cancer could be a risk with cytotoxic agents for multiple sclerosis: "Although several different factors could increase the risk of cervical dysplasia in these patients, the authors concluded that immunosuppressive agents might be a trigger for facilitating HPV to induce abnormal cell differentiation and predispose those patients to premalignant condition" www.ncbi.nlm.nih.gov/pmc/articles/PMC6131331/ It has been previously reported that HPV-dependent cancers are more common in lupus: pubmed.ncbi.nlm.nih.gov/21953088/
My wife is 35 and was diagnosed with MS last year. She did her first full Ocrevus treatment and did pretty good. However about 3 weeks later she’s been having night sweats, not every night just a few nights out of the week. For seemingly no reason. Is this a side effect from Ocrevus or just MS in general? Or, perhaps both?
Most of these are carry over PML (people who previously received Tysabri or gilenya). This is updated as of 3/2022 which shows 12 cases of PML but 10 carry-over cases: www.ocrelizumabinfo.com/content/dam/gene/ocrelizumabinfo/pdfs/progressive-multifocal-leukoencephalopathy.pdf Only of of the "carry-over" cases involved gilenya but not Tysabri
I have been in a crevice now for a whole year and so far so good but I am wondering I’m having some kind of weird side effect with electric shock feeling going down my arm I don’t know if that’s due to this drug or if it’s due to a pinched nerve or something I am however in physical therapy trying to loosen it out if it is a pinched nerve I was wondering is anybody else experienced this with electric shock feeling
Next week I’ll be going for my second Ocrevus infusion. The first was back in September. This whole week I’ve been feeling a flare up occurring. Should I be concerned? Should I change medicine?
They always give me those and today the nurse included a new drug (forgot the name) to go with the Ocrevus. I can't sleep tonight and I don't know if it's due to the drugs or a result of sleeping in the infusion chair for 4 hours.
Ever heard of Ocrevus setting off a flare of comorbid IBD? Like "disruption" of the immune system. My first infusion was completed, and I went into a terrible UC flare about 6 weeks later. Thoughts (related)?
Hi Doctor. I'm from Pakistan my mum was diagnosed by M.S in 2021. She was admitted in hospital for a week after discharge she was ok but on 5 november 2022 she felt a massive headache and only target the left side of his face. She feels that only the left side of her face is burning and the skin changes to yellow bp gets low high . So we take another doctor opinion he said that They have to inject ocrevus inj 4 shots in years its costly for me but the think which I'm worried about is there many side effects of ocrevus i dont know what will happen next if u have better treatment for M.S kindly help me and guide me what to do.
My side effects was first itchy skin that develops then if I scratch into a rash ( so I strongly avoid scratching). My doctor said shingles. I called and infusion staff and they agreed.
@@kandykone88 Greetings. The first two 300 mg infusions were ok until the two weeks before the 600mg full infusion. After the first 600 mg infusion the itchy areas intensified and if I scratched fluid filled blisters that looked a bit like thin chicken pox developed in a couple of areas leaving unattractive scars. I am still breaking out a month later. My doctor shortly after wants to discuss different options. My other mistake was to take contrast with MRI before infusion. I immediately reflected high blood pressure that is going down like honey moving down a spoon in the snow.
*I have M.S. For someone with the J-Virus is there a way, monitoring method, to ensure PML will not develop?* How safe can it be or are there statistics for those on Ocrevus who have the J-Virus? You said it happened only once to a patient who was taking only Ocrevus, did it happen more times to people who where on Ocrevus plus some other medications? Thank you so much for your time.
There are several "carry over" cases of PML with ocrevus in people who previously received Tysabri, though those cases are most likely Tysabri-related as the risk is much much greater with Tysabri. About half of the population is JC virus antibody positive, so this is not considered a contraindication, and the JC virus antibody test is not routinely recommended prior to Ocrevus. That being said, there is no specific way to prevent PML, though receiving the infusion less often to allow b-cell repletion could reduce the risk.
@@DrBrandonBeaber Is there a certain level of immune cells where we know the risk for PML occurs when it is not equal to or greater than that? If so can we monitor the level of immune cells so we know when to receive the Ocrevus infusion less often? Thank you so much for your response and I can't tell you how greatly it is appreciated.
@@andrewkaldas3337 Generally speaking, people treated with ocrevus will have undetectable b-cells for many months after receiving the treatment, so this likely couldn't be used as a biomarker of PML risk. As far as I know, there is only a single case of PML associated with ocrevus in MS (excluding "carry over" cases in those who also received tysabri). Personally, I would be much more concerned about other infections (COVID-19, urinary tract infections, etc).
In the middle of a pandemic doesn’t seem to be time to switch to this drug however my dr is highly suggesting for me too since coming off Tysabri. I’m very scared.
Is Ocrevus more effective than Rituxan? Is the cost of Rituxan really much less than Ocrevus? Does Rituxan have a cancer risk? Why did Roche develop Ocrevus when they already were producing Rituxan for many years?
The two drugs have never been studied head to head, but the results in clinical trials (i.e. OCREVUS in the OROTORIO trial and rituximab in the OLYMPUS trial) are similar. Rituximab is not thought to be associated with breast cancer. Presumably, Ocrevus was developed for economic reasons due to the ending patent life of rituximab, though the pharmaceutical company may claim they had other reasons. FYI, I am a proponent of rituximab and could have a biased perspective.
@@quigonjin6030 There is some evidence that these drugs increase the risk of hospitalization if you contract COVID-19. I have a separate video on this topic: th-cam.com/video/7lMPrMUdPZM/w-d-xo.html
I’ve had 5 Ocrevus infusions thus far with my 6th this November. I read in an MS Society email that the Ocrevus killing the B cells so they don’t excite the T cells and may deflect the covid virus. Is this so? Or has my cogfog confused me once again? I have to drive 175 miles to Portland Oregon there and back with multiple pee stops and a 5 hour infusion. It’s a long day! Throughout my 5 infusions thus far I’ve not had any side effects ever. Hardest part is the boredom so I watch tv on my phone. 🤷🏻♂️ In fact I feel pretty good for awhile even with the constant usual MS issues. My cogfog seems to be worse but that’s it.
I would be skeptical of the implication that Ocrevus would "deflect" the virus. Some people believe that taking immunosuppressants may decrease the risk of acute respiratory distress syndrome with COVID-19 (because it is caused by the inflammatory response). My personal opinion is that people taking b-cell depleting agents like Ocrevus and rituximab should be considered at increased risk of COVID-19.
Dr. Brandon Beaber Thank you for the advice. It just something I read as a possibility. I’m 65 so I’m trying to learn more. I’ll have my 6th infusion this November. I’ve not had a single side effect from the beginning. My infusions consist of a 350+ RT to Portland Oregon and the 5+ hour process. It’s tiring by the end of the day. I have no plans to stop infusions.
@@DrBrandonBeaber Thank you very much for this swift response. You are a great person!!! I have found some hope watching your videos and reading your book. Take care!
@@NYNC88 I find a lot MS doctors really overly positive about MS and the shitty immune system destroying, serious infections and PML causing drugs you have to take to try and control it.
I am on Ocrevus, and it is a blessing to be on it. I have RRMS, and I just recently received my 3rd Infusion. THANK GOD, I haven't experienced many side effects at all. I work very hard on taking care of my body, PRAYER GOES A LONG WAY for Me.
The headaches I experience, I've been placed on an Injection (once per month, every 28 days) which works incredibly well.
I've been extremely lucky to be connected to my Doctor at Yale Medicine.
Thanks for sharing. I hope you continue to do well.
@@DrBrandonBeaber I appreciate the well wishes!!! Thank you Dr. Beaber! 💪💯
You are in great hands there!
Are you still taking it?
@@klassy86 yes, I am still on it. Ocrevus is working very well.
I’m so grateful to you and Dr. Aaron Boster for creating your channels for MS patients like myself 🙂I’m curious to know- when you say Ocrevus is for relapsing forms of MS- what do you mean by relapsing forms ?
The is just part of the label from regulatory agencies (FDA, EMA). Relapsing forms of MS are forms of MS where distinctive relapses/flares/exacerbations/attacks occur (for instance in relapsing remitting multiple sclerosis). Ocrevus is also approved for primary progressive multiple sclerosis based on the results of the ORATORIO trial.
Thank you for your time and sharing, I am going on this medication for PPMS, and this is very much explained❤
I hope it helped.
I am - hopefully - starting Ocrevus soon once the pre-tests have been completed. Thank you for this vid, it is much appreciated and adds to the other info I have been getting about this med. Regards, John from New Zealand.
Your videos are super helpful and make it very clear to understand. I often get lost in all the reports and trying to pull the info im looking for, but your straight to the point on topics and easy to understand. Thanks for what your doing!
Thanks. I really appreciate that. Do you like this style of video using a powerpoint presentation?
@@DrBrandonBeaberI liked it for this video for sure. I wouldn't jump out and say it would be best for all your videos, as I think we have all been through a death by power point in our life. I think a healthy mix of power point back to your video feed depending on your topic would be great!
It really works and helped with my MS, however....more education and research needs to be done in regards to increased risk of cancer. I developed triple negative breast cancer after my 3rd Ocrevus infusion.
Omg. What is triple negative mean?
Please explain I’ve put off doing this treatment because of unknown cancer risk. Would you say it helped or hurt or was it worth it in the end? God bless n thanks
Thank you so much for your incredible videos! I’m 57. Am I too old to start taking Ocrevus? I’ve been on Plegridy for nearly 4 years and my neurologist suggested the switch.
I had this treatment a couple months ago. I now can’t taste my coffee. I won’t do this treatment again. 20 year MS patient. Never conventional treated before. I am going to try the Tao Patch. Thanks for your videos, Dr.
Do you think that this drug will lead to cancer in the future? That’s the only thing i worry about, mind you I still take it despite any risk because I don’t want anymore irreversible neurological damage. Just wondering where we stand now that the drug has been out for awhile.
Very nice video!
Thanks!
Both you guys are just brilliant ❤️ from Ireland 😊
Thank you so much for making this video. I learn a lot from your videos as an MS patient and as a medical student.
Thanks! That means a lot to me.
Question: If I go on Ocrevus (let's say December 2022),, but then have a chance to recieve HSCT about a year or so later, would there need to be a space of days/onths/years time after Ocrevus and before receiving HSCT ? Thanks for all these videos Dr. B, they are so clear concise but carefully detailed for the every person to learn from and ponder options in a balanced way. So, so grateful we all are!
If immunoglobulin levels go down, is it possible to stop the infusions until they go back up again? And also, after couple of years of taking Ocrevus, can the infusions be given less frequently? Is it ever gonna be possible to stop taking it, like with Lemtrada when new, maybe better cells grow back? Thank you!
The metering pumps for the okra reminds me of metering pumps to meter chemicals and to water supplies
This was a very good video. So can you tell me if someone on Ocrevus is able to make any antibodies at all when exposed to a pathogen? Im thinking most of Covid right now. Thanks!
Could you do a mavenclad video? What happens after the 4th year with claridibine?
Thank you so much for explaining! Actually, I had an opportunity to make the change to Ocrevus last year, but stayed on dimethylfumarate for another year, bc I was afraid of PML, and now you're saying the risk is actually lower on Ocrevus.
Omg I am terrified of PML and JVC
I'm on ocrevus since 2018 and have the jc virus... Took me 2+ years to kinda accept it. 2019 my younger brother get diagnosed with ms and just yesterday my uncle who was 33 passed away from pml..... Talk about a living nightmare 😢
@@joshualopez8309 my condolences brother, hope you're doing better
@@martinis_mission8895 hello i just came across ur comment. I was diagnosed last year with rrms progressing type but chose not to b on dmts same reason as u
. Im not willing to risk cancer and pml risks. I would rather have walking difficulties than cancer or permanent paralysis
@@joshualopez8309 hello joshua jyst came across ur comment. Ive commented on the previous comment too. I hope ur doing well and im sorry for ur loss. I hope u dont mind me asking did u get jc positive from ocrevus? And what did the drs say they wud do about it? Im personally not on dmts. Im not willing to take the risk of the side effects. I cant handle 2 diseases. Drs refuse treatng my relapses only because im against dmt. Its just a personal choice.
Thanks for the video. Have you heard of any side effects that include extreme thirst and urination, feelings of blood sugar fluctuations, intermittent cold limbs and lethargy and dry eyes - all decreasing gradually over about 10 days? I've taken Ocrevus since 2017, but the last 4 doses have given me these strange symptoms about 24-48 hours after (perhaps as the steroid wears off). My current hypothesis is something to do with the steroid spiking my blood sugar and my body taking it's time to regulate it (in fact the first time it happened seemed triggered by eating sugary cookies the day after the infusion). The previous years on Ocrevus were absolutely fine. Thanks again.
Hi there ! Were you able to pinpoint why this was happening ? I’ve had similar symptoms while on kesimpta
I'm afraid not. I was told to just change my medication. I start kesimpta in a week. Sorry to hear you have strange after effects. I hope it doesn't persist.
It seemed neither my neurologist nor infusion nurses wanted to understand why I had the symptoms so decided on the easy option of switching to kesimpta. If your symptoms are related to mine then my hypothesis of it being the steroid is defunct.
@@philth123 good luck on kesimpta ! I still haven’t decided what to do about switching to twice a year with O or staying w K. My ins debacle finally alleviated so now it’s just up to me. Praying about it !! I hear ppl have gnarly reactions to O and I’m trying to sort how why that’s (like what it’s caused by) and if I’ll have the same issue since I’m already in a B cell killer. So much to weigh out !! Good luck my friend !!
This was a very good video thanks doctor!
Definitely enjoyed learning more about Ocrevus! I've been on Copaxone (Glatiramer Acetate) for about 5 years now since my MS diagnosis. I had an MRI recently and my neurologist found that I have a new and recent neck lesion. What is a neck lesion? I have been symptom and relapse free of MS ever since I was diagnosed while on Copaxone.
You may want to talk to your own provider, but they are probably referring to a lesion in the cervical spine (the part of the spinal cord which travels through the neck)..
Gotcha! I'll definitely bring it up at my next telemedicine with my neurologist!
What is the likelihood hood of getting cancers from this?
I talk a little bit about a potentially increased risk of breast cancer with ocrevus at around 11:20 in this video: th-cam.com/video/BVhN4_sEi1s/w-d-xo.html
Happy Hump Day! I don't know how folks with rrms are doing on ocrevus, however, it seems a lot who have ppms and are on it are still progressing as if they didn't take it.
Ocrevus is much more effective for RRMS than for PPMS. The data from the OPERA I and OPERA II trials (Ocrevus vs. Rebif in RRMS) are very encouraging, and experience in the real wold reflects this: www.nejm.org/doi/full/10.1056/NEJMoa1601277 In progressive MS, the results are more hit-and-miss as has been the experience with rituximab. The results from the ORATORIO trial (Ocrevus in primary progressive MS) are far less impressive, but it was still a positive trial with statistically significant results: www.nejm.org/doi/full/10.1056/NEJMoa1606468 The reality is that Ocrevus only decreased the probability of progression on the average, and many people in the trial progressed. Also, the inclusion criteria of the trial attempted to select people who were most likely to benefit from the medication.
Thankyou so much for bring there for MS patients like me with PPMS, who have not been given any answers or hope by her doctors.
I would like to ask you, I have a choice between Rituxan & Ocrevus....which one should I ideally take for my condition.
What would be your advice?
I unfortunately cannot give you medical advice here. These two drugs are very similar in efficacy and side effect profile in my opinion.
Acrevus is effective for PPMS with out activity?
Thank you so much for the video!
No problem Luz. I"m glad you liked it
Thank u doctor for your videos... I have a question regarding side effects... I've only started ocrevus in december 2020 ... And i want to ask if extremity swelling could be a side effect of ocrevus or not.. thank u..
Thank you Dr Beaber 😊
What about heart problems, anything to worry about there?
Not if you have a heart condition I’m saying will it cause heart problems.
@@gabes738 When b-cell depleters such as rituximab have been used to treat lymphoma, very severe infusion reactions involving heart problems have been reported, but as far as I know, this has not been an issue with Ocrevus, rituximab, or Kesimpta in MS. Steroids given to prevent infusion reactions can temporarily cause high blood pressure.
@@DrBrandonBeaber just seen your response, definitely happy that you got back to me on this.
So there is a risk of getting cancer? Wow
Very strong medications going into your body
Many thanks for the helpful videos. Is there an obvious reason why Ocrevus would help reduce progression in PPMS but not necessarily do so in SPMS?
Thank you Dr Beaber. I wondered which labs you do routinely on people who are on continuing infusions of Ocrevus?
Complete blood count, urinalysis, lymphocyte subsets, liver function tests, immunoglobins G, A, M. I would only do hepatitis screening and varicella antibody screening once unless someone is high risk.
@@DrBrandonBeaber super thank you for your detailed response!
4.17/1000 chance of a fatal infection is a pretty bad safety profile. Wouldn't most people switch to different treatments?
Thanx for sharing this video.
Hello, thank you for this information. Can you stay on Ocrevus even after getting serum sickness like symptoms? (Joint pain) And how long do those symptoms tend to last? I really like how ocrevus has stabilized my MS and would hate to stop it
Sorry. I can't give you personalized advice here. I would suggest you talk with your provider.
I was getting a histamine release on the second day after. I am not sure why but it has made my neurologist to change my medication. Also I have small veins.
I get histamine reactions w kesimpta too
Hello Dr. Beaber, my son is set to begin treatment on Ocrevus very soon, but only just now did we think to check see if there's a drug interaction with his Probiotic mix that he has been taking. At least 5 strains are listed for their moderate conflict. Should we flush his system of these bacteria? The strains in question specifically were : Bifidobacterium infantis [Bifidobacterium longum subsp. infantis (UABI-13) 0.9+ CFU] , lactobacillus acidophilus [DDS-1] , lactobacillus reuteri [UALre-16] , lactobacillus rhamnosus [UALr-06] , lactobacillus rhamnosus [UALr-18]. Should we delay starting Ocrevus infusion until we're sure these bacteria are purged/all gone? How should we do for safety here to remove these bacteria? I couldn’t thank you enough for your time Doctor and any help you can give would be is so valuable. He was suspected to be at the stage of SPMS [in case that is of any bearing on this consideration]. Thank you.
I can't give you personal advice here. This is the second on the product label with respects to drug interactions, and it does not mention any probiotics: "7 DRUG INTERACTIONS
7.1 Immunosuppressive or Immune-Modulating Therapies
The concomitant use of OCREVUS and other immune-modulating or immunosuppressive therapies, including
immunosuppressant doses of corticosteroids, is expected to increase the risk of immunosuppression. Consider
the risk of additive immune system effects when coadministering immunosuppressive therapies with
OCREVUS. When switching from drugs with prolonged immune effects, such as daclizumab, fingolimod,
natalizumab, teriflunomide, or mitoxantrone, consider the duration and mode of action of these drugs because of
additive immunosuppressive effects when initiating OCREVUS [see Warnings and Precautions (5.2)]. " www.accessdata.fda.gov/drugsatfda_docs/label/2017/761053lbl.pdf
@@DrBrandonBeaber Thank you so much. Your videos are valuable to me.
Hello Doctor : So My girl friend was diagnosed with RRMS 6 years ago, she just had her newest MRI last week and found only 5 new lessions on her spine they found nothing new in the brain , Her neurologist suggested to start "Ocrevus" to slow the progression, she is 22 . It makes sence, but i feel its to early to think of medication. "We are on the fence" with this . can you give us some input on this. Thanks........ Great Channel !
Sorry. I can't give you personal advice here.
You talk about reactivation of previous exposures with Hepatitis. I was wondering if there’s been any link to reactivation of HPV? I dated someone who tested positive for the HPV 16 strain and I possibly carry it. I know there’s some cancer risk associated with that strain and just wanted to check as Ocrevus is a treatment I’m considering.
I am not aware of any specific data on this topic. One article I found speculates that HPV/cervical cancer could be a risk with cytotoxic agents for multiple sclerosis: "Although several different factors could increase the risk of cervical dysplasia in these patients, the authors concluded that immunosuppressive agents might be a trigger for facilitating HPV to induce abnormal cell differentiation and predispose those patients to premalignant condition" www.ncbi.nlm.nih.gov/pmc/articles/PMC6131331/ It has been previously reported that HPV-dependent cancers are more common in lupus: pubmed.ncbi.nlm.nih.gov/21953088/
My wife is 35 and was diagnosed with MS last year. She did her first full Ocrevus treatment and did pretty good. However about 3 weeks later she’s been having night sweats, not every night just a few nights out of the week. For seemingly no reason. Is this a side effect from Ocrevus or just MS in general? Or, perhaps both?
Respectfully, could it be perimenipause. Is that in her family history or could it be a side effect of her meds? Just curious.
now it's 2023 and a total of 11 patients with PML reported from Ocrevus just within the U.S. :(
Most of these are carry over PML (people who previously received Tysabri or gilenya). This is updated as of 3/2022 which shows 12 cases of PML but 10 carry-over cases: www.ocrelizumabinfo.com/content/dam/gene/ocrelizumabinfo/pdfs/progressive-multifocal-leukoencephalopathy.pdf Only of of the "carry-over" cases involved gilenya but not Tysabri
I have been in a crevice now for a whole year and so far so good but I am wondering I’m having some kind of weird side effect with electric shock feeling going down my arm I don’t know if that’s due to this drug or if it’s due to a pinched nerve or something I am however in physical therapy trying to loosen it out if it is a pinched nerve I was wondering is anybody else experienced this with electric shock feeling
Next week I’ll be going for my second Ocrevus infusion. The first was back in September. This whole week I’ve been feeling a flare up occurring. Should I be concerned? Should I change medicine?
Sorry. I can't give you advice on this here.
Has anyone been premedicated with IV benadryl, methylprednisolone, and Tylenol?
Yes. those are typical pre-medications. Famotidine is also used in some cases.
They always give me those and today the nurse included a new drug (forgot the name) to go with the Ocrevus. I can't sleep tonight and I don't know if it's due to the drugs or a result of sleeping in the infusion chair for 4 hours.
@@davidwise3426 Probably the methylprednisolone can cause insomnia.
@@DrBrandonBeaber Thank you for the info, possible.
Ever heard of Ocrevus setting off a flare of comorbid IBD? Like "disruption" of the immune system.
My first infusion was completed, and I went into a terrible UC flare about 6 weeks later.
Thoughts (related)?
What do you think is better for Aggressive RRMS Ocrevus or Cladribine?
Hi Doctor. I'm from Pakistan my mum was diagnosed by M.S in 2021. She was admitted in hospital for a week after discharge she was ok but on 5 november 2022 she felt a massive headache and only target the left side of his face. She feels that only the left side of her face is burning and the skin changes to yellow bp gets low high . So we take another doctor opinion he said that They have to inject ocrevus inj 4 shots in years its costly for me but the think which I'm worried about is there many side effects of ocrevus i dont know what will happen next if u have better treatment for M.S kindly help me and guide me what to do.
If the diagnosis was wrong and I take ocrevus, what would happen?
The most serious potential complication of ocrevus is immunosuppression and infections.
that’s why I’m worried about it , the doctors described it but I think it’s not MS.
My side effects was first itchy skin that develops then if I scratch into a rash ( so I strongly avoid scratching). My doctor said shingles. I called and infusion staff and they agreed.
You developed shingles from your first infusion?
@@kandykone88 Greetings. The first two 300 mg infusions were ok until the two weeks before the 600mg full infusion. After the first 600 mg infusion the itchy areas intensified and if I scratched fluid filled blisters that looked a bit like thin chicken pox developed in a couple of areas leaving unattractive scars. I am still breaking out a month later. My doctor shortly after wants to discuss different options. My other mistake was to take contrast with MRI before infusion. I immediately reflected high blood pressure that is going down like honey moving down a spoon in the snow.
*I have M.S. For someone with the J-Virus is there a way, monitoring method, to ensure PML will not develop?* How safe can it be or are there statistics for those on Ocrevus who have the J-Virus? You said it happened only once to a patient who was taking only Ocrevus, did it happen more times to people who where on Ocrevus plus some other medications? Thank you so much for your time.
There are several "carry over" cases of PML with ocrevus in people who previously received Tysabri, though those cases are most likely Tysabri-related as the risk is much much greater with Tysabri. About half of the population is JC virus antibody positive, so this is not considered a contraindication, and the JC virus antibody test is not routinely recommended prior to Ocrevus. That being said, there is no specific way to prevent PML, though receiving the infusion less often to allow b-cell repletion could reduce the risk.
@@DrBrandonBeaber Is there a certain level of immune cells where we know the risk for PML occurs when it is not equal to or greater than that? If so can we monitor the level of immune cells so we know when to receive the Ocrevus infusion less often? Thank you so much for your response and I can't tell you how greatly it is appreciated.
@@andrewkaldas3337 Generally speaking, people treated with ocrevus will have undetectable b-cells for many months after receiving the treatment, so this likely couldn't be used as a biomarker of PML risk. As far as I know, there is only a single case of PML associated with ocrevus in MS (excluding "carry over" cases in those who also received tysabri). Personally, I would be much more concerned about other infections (COVID-19, urinary tract infections, etc).
@@DrBrandonBeaber Thank you so much :)
In the middle of a pandemic doesn’t seem to be time to switch to this drug however my dr is highly suggesting for me too since coming off
Tysabri. I’m very scared.
I can't give you personal advice, but I wish you the best of luck.
Is Ocrevus more effective than Rituxan? Is the cost of Rituxan really much less than Ocrevus? Does Rituxan have a cancer risk? Why did Roche develop Ocrevus when they already were producing Rituxan for many years?
The two drugs have never been studied head to head, but the results in clinical trials (i.e. OCREVUS in the OROTORIO trial and rituximab in the OLYMPUS trial) are similar. Rituximab is not thought to be associated with breast cancer. Presumably, Ocrevus was developed for economic reasons due to the ending patent life of rituximab, though the pharmaceutical company may claim they had other reasons. FYI, I am a proponent of rituximab and could have a biased perspective.
Any concerns with starting Ocrevus or Rituxan during this COVID pandemic?
@@quigonjin6030 There is some evidence that these drugs increase the risk of hospitalization if you contract COVID-19. I have a separate video on this topic: th-cam.com/video/7lMPrMUdPZM/w-d-xo.html
I’ve had 5 Ocrevus infusions thus far with my 6th this November. I read in an MS Society email that the Ocrevus killing the B cells so they don’t excite the T cells and may deflect the covid virus. Is this so? Or has my cogfog confused me once again? I have to drive 175 miles to Portland Oregon there and back with multiple pee stops and a 5 hour infusion. It’s a long day! Throughout my 5 infusions thus far I’ve not had any side effects ever. Hardest part is the boredom so I watch tv on my phone. 🤷🏻♂️ In fact I feel pretty good for awhile even with the constant usual MS issues. My cogfog seems to be worse but that’s it.
I would be skeptical of the implication that Ocrevus would "deflect" the virus. Some people believe that taking immunosuppressants may decrease the risk of acute respiratory distress syndrome with COVID-19 (because it is caused by the inflammatory response). My personal opinion is that people taking b-cell depleting agents like Ocrevus and rituximab should be considered at increased risk of COVID-19.
Dr. Brandon Beaber Thank you for the advice. It just something I read as a possibility. I’m 65 so I’m trying to learn more. I’ll have my 6th infusion this November. I’ve not had a single side effect from the beginning. My infusions consist of a 350+ RT to Portland Oregon and the 5+ hour process. It’s tiring by the end of the day. I have no plans to stop infusions.
Dr Beaber, is Ocrevus associated with male infertility ? Thank you
Not to my knowledge.
@@DrBrandonBeaber Thank you very much for this swift response. You are a great person!!! I have found some hope watching your videos and reading your book. Take care!
@@pbrane1 Thanks Kostas :)
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Bir de türkçe alt tazınız olsaydı çok memnun olurdum
"Let's have some fun." This "doctor" thinks MS, Ocrevus, and side effects are "fun," or that discussing them is "fun."
I thought it was funny, chill out man
@@mira97652 Not funny. Learn some compassion, "man."
@@mira97652 Yeah, MS is a laugh at minute. Pain and disability are hilarious, so we should all "chill out."
@@NYNC88 I find a lot MS doctors really overly positive about MS and the shitty immune system destroying, serious infections and PML causing drugs you have to take to try and control it.