rituximab anyone?

[grace4et]

if so how are you doing?

[Katje]

what is it?

[Kimba22]

what is it?

This is a chemotherapy drug (aka Rituxan). It is unlikely to be furthered developed for FDA approval in MS. But, encouraging data from MS studies has led to the development of next-generation drugs, such as Ocrelizumab (a drug that my MS Specialist thinks looks very promising). You can read more about them both here:
http://www.mymsaa.org/publications/m...-2013/rituxan/

[Marco]

The Rituximab patent expires in the US in 2015 so further development is unlikely to stave off generic competitors. Instead a humanized drug "antiCD20" (also called Ocrelizumab) was created to ensure profits remain in-house. Both Rituximab and Ocrelizumab are effective in fighting MS being fairly comparable to Tysabri. Ocrelizumab is responsible for a number of deaths and while Rituximab appears to be much safer it will most likely never make it to the MS market.

[grace4et]

i think im going to give it a try! why not right?!=/

[Katje]

rather risk it with HSCT.

[grace4et]

i dont know what hstc is.

[Katje]

Hematopoietic stem cell transplantation

High dose chemo w/ SCT.

[grace4et]

thanks very much

[CrystalBlue]

Any further insight on rituxan? I am waiting for the insurance to get back to me about my cost. If it is an affordable co-pay, I am going to give it a try. I was dx with spms & nothing else seems to be working. Please let me know how it is going.

[Daisy Dead Petals]

spms - had two Rituxan infusions so far. no change for me. added methotrexate lumbar injections... no change for me.

[Myoak]

Thanks for the link, Kimba. “Rituxan® (rituximab)… binds to a receptor on the surface of B cells. These cells are then destroyed and their levels in the circulation are decreased.”
Here we have another highly effective MS treatment which targets B cells. Rituximab kills B cells, Gilenya sequesters them in the lymph system, and Tysabri prevents them from crossing the blood brain barrier.

By targeting B cells all three treatments give support to the hypothesis that B cells infected by Epstein-Barr Virus (EBV) or by Human Endogenous RetroVirus (HERV) play a critical role in MS and that treatment for those viruses which infect B cells may hold the key to effective treatment for MS. The Charcot Project and Michael Pender’s recent success in Australia comes to mind.

Marco is correct, the patent for rituximab will soon expire so now what is called “the next generation” of rituximab is in trial and they call it ocrelizumab. The goal is to get a new patent for ocrelizumab and discontinue rituximab. A new patent will enhance revenue much better than a drug coming off patent.

Marco pointed out ocrelizumab does not appear as safe as the old rituximab, however it appears highly effective so it may be approved. Really provides insight into pharma’s priorities. We have to understand they are businesses and make decisions based on what is best for the bottom line. I’m sure they were expecting to tweak rituximab hoping to make it safer but it does not appear, so far, to have turned out that way.

Ocrelizumab is being trialed in PPMS, also. We should remember these drugs end in “mab” (monoclonal antibody) just like natalizumab (Tysabri). And although the safety profile of rituximab was good having very few incidents of PML, only years of use will establish the safety of ocrelizumab.

It took years before problems appeared with natalizumab in the form of PML. Only time will tell if PML shows up with ocrelizumab; it is possible that it will be safer than Tysabri and just as effective. Possible it won’t be on either count. In any case, it doesn’t appear as safe as rituximab was. So if you have access to rituximab you may want to stick with it for now.