Why Do We Turn Into MS Monsters Just Before an Ocrevus Infusion?

[KoKo]

I found this interesting. Maybe those who use Ocrevus can relate?

"The crap gap is the slang term for the two-to-four-week period before an infusion of Ocrevus, when the last dose is wearing, or has worn, off. It’s not an official diagnosis, but it’s familiar to anyone who routinely takes a strong medication. Many professionals not only accept the gap as a very real phenomenon, but also explain the return or worsening of symptoms as simply the signs of a withdrawal."

Things Get Tough While I Wait for Ocrevus for Multiple Sclerosis | Multiple Sclerosis News Today

[Marco]

I'm on rituximab, the forerunner to ocrelizumab and crap gap can occur with it as well. Unlike ocrelizumab, rituximab is not approved for MS so it is prescribed off-label.

Fortunately, there's no standard protocol for rituximab infusions so there's a lot more leeway in how it is dosed. I know patients that are on quarterly dosing to prevent crap gap and others are on extended dosing schedules. I am currently on a 15 month infusion cycle.

The Ocrelizumab infusion schedule can be shortened, but requires special permission from the neurologist to the insurance companies. This should alleviate crap gap in most cases.

If crap gap problem persists the patient could consider ofatumumab since it's dosed monthly (after the initial start up period).

My 0.02...

I wish you well.

[oceanpride]

I noticed this a good two months before my last infusion.
I chalked it up to having Covid right after the prior infusion.
I figure between Ocrevus and Covid everything would be messed up.

[lukeduke]

Well I can't speak for Ocrevus but on Tysabri my wife used to say that when I was getting ready to go for my Tysabri infusion it was like I was having my period. Of course that was when I was going to Shepherd center and that Dr wouldn't let me do the Tysabri anywhere but there.