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Going off Gylenia for Ocrevus

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    Going off Gylenia for Ocrevus

    My MS doctor has suggested switching as my MRI's are showing changes, although I'm not having any major relapses. But she said I would have to come off Gylenia for a couple of months before starting Ocrevus.
    This SCARES me!
    What if I'm not taking anything and relapse?? Anyone have experience with this?

    Thanks

    #2
    Originally posted by elmo2010 View Post
    My MS doctor has suggested switching as my MRI's are showing changes, although I'm not having any major relapses. But she said I would have to come off Gylenia for a couple of months before starting Ocrevus.
    This SCARES me!
    What if I'm not taking anything and relapse?? Anyone have experience with this?

    Thanks
    The washout period switching from one DMT to another is usually as brief as possible in order to minimize relapse potential. So yes, there is some risk, the degree of which should be a topic of discussion with your doctor to address your concern.

    Another very important point to discuss is the coronavirus and the wisdom of switching DMTs to Ocrevus, an anti-CD20 B cell depleter which exposes you to much greater risk from serious infections like coronavirus. It may be prudent to wait until coronavirus plays out (hoping to does play out!).

    I predict a good number of MSers will come off of Ocrevus in hopes of re-constituting infectious fighting B-cells to guard against coronavirus.

    BTW, for my friend Kris on Tysabri in Montana if you are reading... Ocrevus appears to have a serious infection rate of 19.7 per 1000 person years versus Tysabri at about 11.4 per 1000. Gilenya's rate is 14.3. Interferon at 8.9 and Copaxone with the lowest rate of serious infection at 5.2 per 1000 patient years. Please understand that Ocrevus has not been around long enough for this 6 year study, however, rituximab has and they both do the same thing which is deplete (kill) CD20 B cells. So, the infection rate is the same for both Ocrevus and rituximab.

    https://jamanetwork.com/journals/jam...stract/2752284

    It is very, very likely, IMO, that coronavirus will become pandemic in the US and if it does it will present a real danger to MSers, in particular because MS DMTs weaken the immune system, some more than others, however, few more than Ocrevus.

    About 24% of MSers die from pneumonia. Coronavirus is a fairly devastating respiratory virus and, IMO, presents huge risk to MSers. Every step we can take to minimize risk is prudent, IMO. There would need to be a compelling MS related reason to switch to Ocrevus with the possibility of pandemic coronavirus on the horizon, JMHO.

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      #3
      Myoak, thank you for this important information.

      Take Care
      PPMS for 26 years (dx 1998)
      ~ Worrying will not take away tomorrow's troubles ~ But it will take away today's peace. ~

      Comment


        #4
        Thank You, Myoak - appreciate this! I just made the Jama Network finding mentioned here into a Sticky thread.

        https://www.msworld.org/forum/showth...umab-Rituximab
        1st sx '89 Dx '99 w/RRMS - SP since 2010
        Administrator Message Boards/Moderator

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          #5
          Thank you Myoak!
          Great information, and I have lots to think about!

          Comment


            #6
            I say - GREAT - and you are going to be so happy you made the change. I relapsed and progressed on Copaxone and Tecfidera… now 2 years in to infusion therapy - nothing - not a single new, enlarged, active legion on any MRI and zero relapses.

            The point about waiting for Coronavius to settle is valid - I absolutely get more colds and minor viruses than I did before - but I'll take a cold over a new lesion!

            Good Luck!

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