Briumvi?

[Guest]

Dear folks, I am going to have to change my DMT, and looked at Briumvi online it looks like a good similar treatment to Ocrevus and a little bit less expensive, and it looks like I may quality for financial assistance through their program. Has anyone here had any experience with it? Thank you for your assistance

[Mamabug]

Bumping this up, in case someone with Briumvi experience can respond.

[Kimba22]

Hi bentbikeguy,
I'm surprised you're the first person who's asked about Briumvi. It was FDA approved over a year ago. (I noticed Briumvi is not listed in the Medications and Treatments subforum, so would a moderater please add it, and move this thread there?)

Briumvi is a disease modifying treatment (DMT) for MS, not a symptomatic treatment. The primary function of a DMT is to alter the course of the disease. In MS, the overall goals of DMTs are to lessen relapses and lesions and to delay disability. Other therapies are required for symptom management; these may include medications for cognitive impairment, depression, fatigue, gait impairment, spasticity, tremors, seizures, bladder dysfunction, and erectile dysfunction.

I don't have experience with Briumvi, but have been on Ocrevus over 5 1/2 yrs now, and it's the only DMT that's really worked for me. I've taken several different ones since my diagnosis more than 20 years ago. If it was available then, I'd probably still be walking.

The main differences between Ocrevus and Briumvi is that Ocrevus is a humanized anti-CD20 monoclonal antibody (mAb), while Briumvi is a chimeric anti-CD20 mAb, and which part of the CD20 receptor it binds to. CD20 is a surface protein located on B cells (a type of white blood cell). Briumvi has a shorter infusion time than Ocrevus. Both are given every 6 months.

Here's further information about the four different anti-CD20 mAbs used for MS ~

• Rituximab is a chimeric anti-CD20 monoclonal antibody (mAb), commonly used for off-label treatment of MS, and was the first anti-CD20 monoclonal antibody to show efficacy on measures of inflammatory activity in a phase 2 clinical trial in patients with relapsing remitting MS (RRMS), as well as in observational settings. The patent for this drug expired before phase 3 MS trials were done. It was first FDA approved for the treatment of patients with non-Hodgkin's lymphoma in November 1997.

• Ocrevus (Ocrelizumab) is a humanized anti-CD20 monoclonal antibody that binds to a different but overlapping epitope than Rituximab does. (An epitope is the part of a protein that an antibody recognizes and binds to.) It was FDA approved in March 2017 for RRMS and is the first and only DMT approved for PPMS. Since ocrelizumab is derived mostly from human antibodies, it induces less of an immune response to foreign antigens. This reduces the chance that a patient’s immune system may form antibodies against the medicine (known as anti-drug antibodies), which would decrease the effectiveness of the medicine over time.

• Kesimpta (Ofatumumab) is the first fully human anti-CD20 mAb approved for the treatment of RRMS and it can be self-administered at home. It was FDA approved in August 2020. The membrane epitope recognized by Kesimpta encompasses both the small and large loops of CD20. In contrast, rituximab and Ocrevus' binding sites on CD20 involves only the large loop. Kesimpta is a subcutaneous injection. Initial dose of 20 mg at Weeks 0, 1 and 2 for initial B-cell depletion; with a maintenance regimen of subsequent 20 mg in monthly intervals starting from Week 4. The constant near-complete B-cell depletion seen with Kesimpta is believed to have advantages in terms of efficacy (disease control) and safety (less risk of severe systemic injection/infusion reactions).

• Briumvi (Ublituximab) is a chimeric, intravenously administered anti-CD20 mAb, binding to a different epitope on the CD20 receptor compared to rituximab and Ocrevus. It was FDA approved in December 2022. Briumvi is the least expensive of the FDA approved DMTs, followed by Ocrevus. It also has a shorter infusion time of 1 hour after the first dose. Here's what to expect on infusion day: https://briumvi.com/infusion-experience/
Ocrevus has 2 different infusion times after the first dose; 3 1/2 to 4 hours, or 2 hours, as long as the patient hasn't had a serious infusion reaction to the medication. (Infusion day for Ocrevus https://www.ocrevus.com/patient/infu...E&gclsrc=aw.ds)

On a side note, the World Health Organization (WHO), designates mAb treatments as chimeric (-xi-), chimeric/humanized (-xizu-), humanized (-zu-), or fully human (-u-).

Chimeric (-ximab) - 65% human (Rituximab aka Rituxan, Ublituximab aka Briumvi)

Humanized (-zumab) - > 90% human (Ocrelizumab aka Ocrevus)

Fully human (-umab) - 100% human (Ofatumumab aka Kesimpta)

I hope this information was helpful to you. Please let us know if you decide to go on Briumvi and your experience with it. Best wishes.

[Kimba22]

Additional info:

Anti-CD20 mAbs target a cell membrane protein, “cluster of differentiation 20” (CD20), which is predicted to have four transmembrane helices with two extracellular loops.

Although all anti-CD20 mAbs bind to the same target, they have distinct molecular and pharmacological features. Rituximab, an IgG1 mouse-human chimeric mAb, binds to amino-acid residues 168-175 on the large extracellular loop of CD20. Rougé and colleagues also demonstrated that two rituximab Fabs could bind each CD20 dimer to form a circular rituximab-CD20 assembly that could allow complement recruitment. Ocrelizumab (Ocrevus) is a humanized glycosylated anti-CD20 IgG1 mAb that targets the large extracellular loop of CD20 on amino-acid residues 165-180, a different but overlapping epitope to that targeted by rituximab. Ofatumumab (Kesimpta) is the first fully human IgG1 mAb approved for the treatment of MS. Ofatumumab binds to discontinuous sequences of the small (amino-acid residues 74-80) and large (amino-acid residues 145-161) extracellular loops of CD20. Ublituximab (Briumvi) is an IgG1 chimeric mAb with a glycosylated Fc segment that enhances affinity for FcγRIIIa. It binds to amino-acid residues 158-159 and 168-171 on the large extracellular loop of CD20.

https://www.frontiersin.org/journals...3.1004795/full

[KoKo]

Hi bentbikeguy,
I'm surprised you're the first person who's asked about Briumvi. It was FDA approved over a year ago. (I noticed Briumvi is not listed in the Medications and Treatments subforum, so would a moderater please add it, and move this thread there?)

Will do! Thanks Kimba!

[Guest]

Thank you so much for your feedback I really appreciate it the way you presented the information seemed somehow more accessible than the information I have found myself thank you again Robert