Ocrevus vs. Kesimpta for Multiple Sclerosis. Comparison Between the Drugs, Efficacy, Side Effects
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- čas přidán 27. 10. 2020
- Ocrevus (ocrelizumab) and Kesimpta (ofatumumab) are two drugs for multiple sclerosis which both work on b-cells. In this video, I explain differences between the two drugs and results from clinical trials. Which drug has fewer drug-reactions? Which has a lower rate of serious infections? Is Kesimpta more optimally dosed?
Sources:
Subgroup analysis of OPERA trials: www.ncbi.nlm.nih.gov/pmc/arti...
OPERA trials: www.nejm.org/doi/full/10.1056...
NEJM article summarizing the ASCLEPIOS trials: www.nejm.org/doi/10.1056/NEJM...
Comment or ask questions below! I would be happy to answer!
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My book "Resilience in the Face of Multiple Sclerosis" on Amazon: www.amazon.com/dp/B07WP7H5LK
Dr. Brandon Beaber is a board-certified neurologist with subspecialty training in multiple sclerosis and other immunological diseases of the nervous system. He is a partner in the Southern California Permanente Medical Group and practices in Downey, California (South Los Angeles). He has several publications on MS epidemiology and has participated in clinical trials for MS therapeutics. You can follow him on twitter @Brandon_Beaber where he regularly posts about MS news and research.
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The video material by Dr. Brandon Beaber is general educational material on health conditions and is not intended to be used by viewers to diagnose or treat any individual's medical condition. Specifically, this material is not a substitute for individualized diagnostic and treatment advice by a qualified medical/health practitioner, licensed in your jurisdiction, who has access to the relevant information available from diagnostic testing, medical interviews, and a physical examination. To the extent that Dr. Beaber endorses any lifestyle change, behavioral intervention, or supplements, the viewer should consult with a qualified healthcare professional to determine the safety and efficacy of the intervention in light of their individualized information. - Věda a technologie
I am sending a hug to anyone who is scared now. I wish I could just be there with you, sitting in silence.
Thank you so much
I'm fairly new to Kesimpta. I started it in January 2023 and I like it. No allergies, no adverse reactions, no infections, nothing negative about it for me. No relapses, brain fog, no seeing little black spots. Nothing, I am grateful 😊
How much does it cost?
@@mariasaqib7940 the cost, I don't know. I just order it and take the injection once a month. 🤔 I never thought about how much but I'll look into some things and let you know.
I been on kesimpta and I definitely have the little black spots, I didn’t have them until I started it and then one day started noticing… I’m only on my 2nd month dose
@@armanidarling8700 that's weird but it doesn't leave black spots on me so I don't know what that what that could be about
@@armanidarling8700on the injection site or what?
Switched from Ocrevus to Kesimpta and have experienced monthly joint and muscle pain along with a facial breakouts. Switching back to Ocrevus where I had nothing but improved quality of life for 2 years. The switch was made due to concerns over the breast cancer risk. This video helped me to understand those concerns a bit better. Thank you.
consider briumvi.. no breast cancer reported on their trial and now available since feb 2023.
Thank you Dr. Beaber for doing such informative videos for us.
Very good summary! Thanks for this video.👍
Thank you so much for all this information, my husband is treated with Ocrevus (this is the way it is written here in France) and was asking himself if he would not change for Kesimpta (this is also the way we write it in France) and your help is absolutly great! Thank you 😃
Thank you for the information. My wife will start Kesimpta treatment soon. We are nervous and your i for
Action is very helpful. Thank you 🙏🏼
Just found this video. Great explanation of the differences and similarities. I was on Ocrevus for a year and a half and then switched to Kesimpta. I've been on Kesimpta for a year now. From a patient experience, I find Kesimpta so much better. The Ocrevus infusions felt like a big deal on infusion day and for the next few days after. Not to mention the steroid and antihistamine protocol before receiving Ocrevus. With Kesimpta, it's just a quick shot and I go on about my business. I rarely ever feel any difference in my body after the shot.
I am glad to hear this because I’m considering switching from Ocrevus to Kesimpta. I’ve been doing well on Ocrevus but I have just been scared of what it does to our immune system during this pandemic.
What type of MS do you have?
@@Mala4734 I totally understand that. I’ve now had Covid twice. The first time was the hardest, probably two different variants. In both instances I didn’t take any kind of Covid treatment. It took a few weeks to fully recover but my immune system was able to handle it. I did have the vaccine and boosters.
@@jimkimbrough5 I have RRMS. I was diagnosed 10 years ago, though I’ve had symptoms for 11. Started on a clinical trial of Gilenya. I got shingles, which I wasn’t told was a possibility. I switched to Tecfidera and took that for 5 years. It tore my stomach up. I had a new attack 5 years ago and the doc felt the Tecfidera wasn’t being effective anymore. Started Ocrevus 4 years ago, and did that for one year and then to Kesimpta. I’ve been on that ever since. Since the Ocrevus/Kesimpta, I’ve had no new activity or worsening disability.
@@eldinjohnston8836 so encouraging to hear that you’ve had no issues the past few years! Thank you for sharing!
Really appreciate your videos! Great information. Thank you!
I'm so glad I found your channel! My mom was diagnosed with MS after YEARS of being treated for fibromyalgia 🥴. I haven't understood her condition and have felt a little unsupportive for some time. I'm hoping to learn more about MS to support her more. I appreciate the in-depth explanation of these drugs too. Idk if she takes anything like this so I'm happy to have something to share 🤗. Thank you
I'm glad it's helpful. Let me know if you have any video suggestions.
GEM, don't feel bad. MS is such a mysterious disease that not even the person diagnosed knows what's going on the majority of the time. Continue to be a support with love and patience. Remember, there will be some frustrating days for you, but for your mom also. Research about the disease is a great way to know what to expect. I'm sure people probably said your mom is lazy but that's not the case, she's being attacked by this disease, which can attack at any given time. I can speak on it because I was diagnosed August 4, 2012. It's a journey for sure that can feel lonely because not everyone knows what it entails. I am proud of you for wanting to know, help and understand.
💙 For you. 🧡 For your mom, orange is the color that represents for the Multiple Sclerosis community.
Thank you as always for the time you put into these videos! Information always brings a bit of calm to all the craziness.
My neurologist is recommending Kesimpta as my first treatment, so trying to find out as much as I can!
Here's an overview of Kesimpta if it helps: czcams.com/video/IIBBlvnPjS0/video.html
I've had 2 Ocrevus doses so far, about to have my third, and I've noticed each time that I've had what feels very much like a relapse and persistent worsening of symptoms sound the 4-5 month mark. When I read that Kesimpta is a monthly injection my first thought was 'does that mean no crap gap?' because of the more consistent dosing. I am very keen to speak to my consultant about this, as I'm concerned that more permanent damage is occurring every time I am coming up to my next infusion.
Very informative Dr Beaber. Many thanks.
Thank you for the great video Dr.Brandon. I have a suggestion/request for a new one: upcoming drugs for MS that are likely to be released in the next years
Sure. I'm going to post a video on masitinib in a little while. I may do on on ibudilast as well along with intrathecal mesenchymal stem cells.
Helpful, as I’m trying to decide between the two right now.
I'm glad it was helpful
Love these videos.
Thanks!
Very happy and appreciative of the video. I’m currently on ocrevus and contemplated changing to kesimpta. I wondered how the two B cell depletions would compare. Very informative. Thank you ! I think for now I’m going to keep the course only because I seem to be doing well. And I don’t know how I feel about injecting myself. Haha. I’m a nurse and find it odd that I’m fearful of injecting myself. 😊. Have a nice week
:) I'm glad you enjoyed it. Lots of nurses and doctors are needle-phobic in my experience. You would probably get used to it though.
Samantha Foor I’m reading your comment with a giggle. I also am a nurse and would like to try kesimpta for that very reason 🤣
Thank you for making this video! Very helpful!
I'm glad you enjoyed it Eric. Let me know if you have any video suggestions.
You're amazing Dr. Beaber. I love the time you take every week to help us to understand what the heck is injected into our bodies via Infusions or Injections!!!
Thanks! Let me know if there is any particular topic you would like a video on, and I will make a note of it for later.
Thinking of switching to Kesimpta from Ocrevus, so I’m glad that I searched your videos and found this. I’ve been on Ocrevus for a little over 4 years and the infusions just completely wipe me out and I also get the “gap crap” around 3 1/2 months now. Will continue to weigh my pros and cons. Thanks again for the video!
Best of luck with Kesimpta Jessica
Did you ever decide?
@@jasminraja9810 I finally did decide. I switched to Kesimpta in September 2022. It has been an easy transition and for me personally, I don’t have to do all the pre meds prior to taking the injection, which is huge!!
I was one of the few (rare) patients with MS that would have reactions every time I had my Ocrevus infusion and would need extra IV steroids and benadryl; sometimes more than once and that would totally wipe me out.
I was on Ocrevus just shy of five years prior to switching.
I am experiencing the crap gap after 3 1/2 months with ocrevus. Do you recommend switching to Kesimpta ?
@@gdminc4819 that is something that you should discuss with your neurologist. Everyone’s experience is different. You’ll need to have that discussion, do your research and then make an informed decision that is best for you. 🧡
This is so helpful! Brings up a few questions I have for my upcoming appointment with my specialist! I am currently on Rituxan which has caused me to have low IGg levels. Currently combating that problem with monthly IVIG. I’m wondering if trying out either of these with differing dosages than Rituxan might help with my IGg levels. I plan to ask my neurologist next week! Thank you for the informative video!
Love this Dr. Beaber! Thanks so much. I was dx with MS in November 2000. Lucky to have not had very much progression of the disease.
I kept quiet about having MS (Multiple sclerosis) for over two decades. I lived and battled my MS in the shadows. Why? One of many examples of living with a chronic disease when people don't know you have it, I had an employer take myself and another lady into a backroom and tell us “Don't hire anybody with a chronic disease like MS our insurance rates are going through the roof!” He didn't know I had MS.
Another employer told me behind closed doors, “I wished more of the employees kept in shape like you, we have a couple of fatties that are diabetics, and they are driving our healthcare costs up.”
Age and health status discrimination is alive and well because our healthcare costs have skyrocketed.
I have friends that are self-employed married couples, 60 yrs. old, that makes too much for the subsidy and they can’t afford healthcare. What a crime!
And….
I've had doctors that didn't know I had MS say some mortifying stuff in front of me that they didn't know what they were saying was unethical and scary!
But I've also had one of the top oncologist doctors in Idaho that have told my story above and they actually started crying and said that the United States medical system is corrupt, his exact word were, “It’s f#cking corrupt!”
My third book will be about what I have seen and heard living with a chronic disease on others not knowing it. What I saw and heard will terrify you.
Interesting, I'm looking forward to Kasimpta.It's more pragmatic for me as I'm still a student undergoing another CD-20 depleter.I think Ofatumumab and Ocrevus are similar like you mentioned Doctor.My concerns are more linked to the degree of toxicity that Ocrevus could engender in my case.In general,those seam like effective DMTs & I'm already positive I'll make the good choice with my healthcare team(HCT).thanks Doc. looking forward for more videos like these :)
Ive just been diagnosed with ppms and about to start ocrevus treatment. Im really struggling with life and so desperate to get some relief and recovery.
Thankyou for this video im sucking up as much information as i can but have doubts about a lot of claims made. This video is clearly facts and results based and nothing else
Thanks. I'm glad it helped.
Dr. Brandon, thank you very much for this video showing the most important facts of each drug and stadistics which I find very useful. I am PPMS patient who has been taking since 2018 Ocrevus. I must say that I haven't had any hard side effects on my body and how I feel overall. Unfortunately the disability is affecting me more every year. I know this is not a cure and the disability that I am experiencing are the simthomps of the initial damage that the MS did to my brain and spinal cord,however after 12 years of that t terrible Diagnose I still can walk (with difficulty ) and I am thankful that I still can have a normal life.
Thanks for sharing Juan
Thanks so much for this invaluable summary Dr. Beaber! I have been taking Tecfidera since 2019, and before that Avonex. Although they have worked to some degree, it is not really protective. So I will probably switch to an immune suppressor to prevent disability as much as possible.
I'm glad it was helpful Yunus and best of luck to you.
Excellent view and comparison...timely too. Heading for an infusion in a couple of weeks and hope to switch to Kesimpta before next infusion. With efficacy being virtually the same, the convenience is not even close for me as the infusion center is an hour and a half away. My first dmt was rebif so subcutaneous injections is something I've done and with the autoinjector pen not a big deal at all. Thanks for the videos and keep them coming!
Thank you very much ! this video is helpful. You basically covered everything I should discuss with my doctor. I have to choose between them and for me I think it's fairly reasonable to consider the ( the how long it's been used) factor! . Kasimpta is fairly new and a 70 years old man died because of PML after using it . it will be very useful if you talk a little about the those drugs and JC virus and the possibility of the JC virus activation that leads to PML fatal brain infection. Thanks a lot !
That scared me too when I read it on my drug sheet the neurologist gave me. I would like to note that I did research and found that cases of PML were only found thus far when the drug it self was originally used as a way to treat a form of blood cancer, this was substantiated after speaking with a nurse practitioner at my MS clinic. I also think that for anyone who is scared of PML to note that it is rare and more common in older populations. As a 26 year old otherwise healthy man I decided to go with this high efficacy drug as my first line choice.
What you said about the dosing is interesting. For me, ocrevus hasn’t really stopped progression in any form. Actually, I progressed more on ocrevus than without it. I’m also 245lb lean @ consistent 10-12% BDF. I would love to take part in a trial with a higher dose to see if it makes any difference.
I'm not sure if they are recruiting yet, but you can follow the clinicaltrials.gov page to see if they post contact information: clinicaltrials.gov/ct2/show/NCT04548999?cond=ocrevus+PPMS&draw=2&rank=1
This is separate request- can you do an updated video talking about different types of MS and allied disease including tumerfactive MS and NMO?
Yes! I have already filmed and uploaded a video on MS subtypes along with a separate video on NMO. Stay tuned.
Thank for the video.
Thanks for this info.
Thank you for the videos, Dr. Beaber. Any input on the patients reporting the "crap gap" with Kesimpta? I currently am taking Ocrevus, but about 10 weeks before my next dose I start to feel a "wearing off" effect. Seems early I know. My neurologist wants to switch me Kesimpta hoping dosing more frequently with Kesimpta will address this. At my last visit, nobody at the clinic was on Kesimpta being it was just approved. So it's just a theory it'll help reduce the "crap gap" period, but nothing has been reported. Your opinion please. I am also glad you touched the issue about under dosing Ocrevus. I have higher BMI, over 30. This is why I think I have this wearing off effect so early leading up to my next infusion.
I think it is too early to tell if people will start reporting a "wearing off" effect of Kesimpta. The reason people experience this is very unclear as many people have sustained b-cell depletion with Ocrevus even more than 6 months after they have received it.
It's so wonderful to have found your channel and this post in particular.
I'm coming into my fifth dose of ocrevus this month (late feb 2022) and have had concerns with the drop down in the gap each time. Since it seems here that kesimpta is comparable to ocrevus I am wondering if the more even dosing of kesimpta might alleviate the drop down in the gap?
I see that it's one year since you posted this. Would you have any update to offer? Have you found that the more frequent dosing makes any difference for your patients?
Hello Norma, what do you mean by drop down in the gap ? I’m in the phase of switching drug and i’m confused between Ocrevus or Kesimpta 😑
@@AA-ex5nqwhat did you decide?
Thank you very much Dr. Beaber, super helpful! I Have a question about the statistics of the New or Enlaging Lesions. Were the tested time periods the same in Opera and Asclepios? (I guess they were but for the others you specifically mentioned the time periods) And are there, now, one year later, maybe further studies concerning increasing lesions? This would be actually my #1 decision point, since I (gladly and so far) only see progression in the amount of lesions in my brain... I would be incredibly thankful for an answer. Best regards
These trials ae 2 years long.
Thx, very informative
Please look for and review the Phase II Trials of NurOwn. It is developed by Brainstorm Therapeutics and will be releasing phase ii results at the end of November. Thanks for these amazing videos!
I am a US citizen in Brazil who was prescribed to Ocrevrezaub by my neologist. I would love to try this drug.
Thank you for this informative video. What vaccinations should be given before taking kesimpta? Greetings from germany...
Was prescribed Kesimpta but hesitant to start it because of the PML side effect risk.
Overwhelmed with treatment plan and researching the medication options.
Hi Deborah, Did you decide about what medication ?
Same.. did u decide?
I'm switching from Ocrevus to Kesimpta to see if I can fix the 3 month crap gap I have consistently and repeatedly experienced with Ocrevus. You point about dosing is an interesting one. I'm 6'3", 178 lbs and Ocrevus only seems to help with symptoms for the first three months, then all the issues come back, like clockwork.
Hopefully Kesimpta works out better for you.
I have ms and I’m on ocrevus I just found you love this
I just took my first dose of Kesimpta last Friday. I’m noticing my skin is breaking out? Saw a comment saying the same thing. Is this related? Thanks. Great video, I had to choose between these 2 drugs.
Hello Dr. I was wondering what your opinion is regarding Kisempta and PML?
Very informative. Thank you. Can you do one comparison between ocrevus and ublituximab? As they are both administered via infusion.
I will probably do this if ublituximab becomes an approved product.
Lots of good data in the video. Was on O, switched to K. Much happier.
FYI your gadolinium slide says gadinium.
Thanks. Sorry about the typo.
No side efects on Ocrevus so far (had 2 doses of 300mg) Took about 8 months to get my B-cel count at 6 thousand/ml. I can get a new dose when its >10, should be somewhere next month. Full dose this time so hope its gonna go well again. Keep up the good work Doc!
Hello. Do you have anymore updates
@@mariocerda335 I had no side effects during or after infusion, didn't even made me tired this time. If it works for me as an PPMS patient I'll probably never really know. But this is about doing everything to battle this disease. I am not a doctor but I will advise you to go with the best and strongest DMT you can get your hands on and see how that goes. Search for flipping the pyramid. I wish you all the best!
Next 300 ml ocrevus for me tommorow. No side effects at all the first time either.
Very informative video, thank you so much! I have been on Ocrevus for years now and have been doing well on it, but I tested positive for Covid the day I was supposed to have my last infusion and I have been scared to do anything since. It was suggested I switch to Kesimpta because it doesn’t deplete as much of our immune system and that patients “seem to do better with Covid” on Kesimpta as opposed to Ocrevus. I was wondering if you might possibly have any information on that? Thanks ☺️
I don't have any specific data on this, but the dosing of kesimpta is generally speaking more conservative (in its clinical development, the minimum doses needed to stop gadolinium enhancing lesions in phase II trials was used)
Thank you so much for these amazing and helpful videos! I am currently on Ocrevus, but I have had a few not-so-great experiences at my infusion center. I also feel wiped out after my infusions. Do you feel that since kesimpta does not require Benadryl the experience could be a less draining one?
I am also curious as to which one you would recommend more for someone looking to become pregnant in the future. You had mentioned the half-life of ocrevus was something to be noted when considering the possibility of pregnancy. I am a little nervous because in the U.S it seems 6 months after your last infusion is the recommended amount of time, however in the UK, they recommend 12 months. Do you feel that kesimpta's six-month recommendation is more realistic in its recommendation vs. ocrevus's?
Thank you for any and all information in advance!
Usually Kesimpta is not given with preventative medications such as benadryl. I do have an opinion on the pregnancy question, but I don't feel comfortable posting it here. I would suggest speaking with your own provider.
@@DrBrandonBeaber Thank you for your response. :-) It would just be more of a relief if the US and the UK were on the same page with their recommendations. The UK tends to have better standards for what is given to its citizens overall, (Food and cosmetic wise) so it was concerning to read of any differences.
I had an appointment with my neurologist shortly after posting my last comment. He mentioned that doctors are considering Ocrevus becoming a once a year infusion, which would be a huge game-changer if that happens.
He also mentioned that a 12-month wait is extra cautious, that many people become pregnant 5-6 months, or even sooner after their infusions without issues. Also, it takes time to become pregnant, so even if you wait 6 months, it could end up being an 8-12 wait anyway.
These are all excellent points, that I wanted to share. I still feel that the more cautious the better, 6-12 months, but it was nice to see the U.S recommendations backed with some studies and reason to them.
One thing my infusion center offered after the Ocrevus infusion was a bag of fluids, this helps tremendously.
@@amitrippen8170 Yes! Water helps. Also, my infusions have gotten shorter, (now only 2 hours) and the amount of Benadryl they are giving me is less, so it is not as unpleasant these days.
@@amitrippen8170 What is the bag please ?
Thank you, well explained. Tomorrow is infusion day but fingers crossed I have opted to switch to injectables. Why, the convenience
I've been on both. Was on Kesimpta for one of the trials and had 2 relapses on it (confirmed was in the active arm). After the trial (20 months) I went on Ocrevus. I personally have done much better on Ocrevus. It did take 3 rounds of Ocrevus for my relapses to finally stop. I think both are worth considering and I'd consider going back onto Kesimpta at this point because I feel like I needed a much higher dose at one point and don't anymore. I've had no side affects on either. I agree that the dosing should be further investigated. It would be interesting to know what the weight the chosen dose is based on. I'm not a particularly large person but nor am I a light weight.
Personally, the brain athrophy side of ocrevus is a win for me by itself. The long term studies for ocrevus are amazing. It would be interesting to see ocrevus compared with this drug in the long term for sure. I believe there is a study comparing ocrevus to the same drug & I believe that showed ocrevus was better. I believe it was your video which pointed out the brain atrophy element of ocrevus.
There is a recent publication on the 6.5 year follow up data from the OROTORIO study (Ocrevus vs. placebo in PPMS), and I'll do a video on this soon. Obviously, we have no long term data on Kesimpta.
Hi, I’m on hold for HSCT at the moment but would you say that taking Ofatamumub could be something to take in the meantime? Ocravus is one I’m not willing to take
Thank you, Im concerned about the infusion of Ocrevus and like the quick convenience of Kesimpta they seem to close to decide which one is better its more of a matter of how you take it. I have heard horror stories of blown veins with Ocrervus and what not, not something I would consider pleasant. Again I appreciate this video , Im concerned about the appendicitis!
Maybe I'll do a twitter poll to see which people would prefer overall. The appendicitis may end up being a red herring, but we shall see over time.
Doc, are you familiar with ublituximab which demonstrated an ARR of
Yes. I will do a video on it when it is approved.
Thank you for providing this very informative video - still debating switching from Ocrevus (or going 5 instead of 6 months bc of B cell regeneration and feeling poorly) to Kesimpta. Was wondering if you could expound on the ramifications of the difference in their half lives of 26 days into 6 month O infusion and 16 days into 30 day K injection.
Hi doctor
Amazing video!!
I have a question please
Is it safer to take Rebif VS Ocrevus in regard of Corona virus, hence Ocrevus is a strong immunodepressant and interferon 1-a(Rebif) would be a much safer choice.
Thank you for your time.
There is some evidence that b-cell depleters such as ocrevus, rituximab, and kesimpta may increase the risk of hospitalization with COVID-19. beta-interferons such as rebif are likely safe and not expected to increase risk. I have a separate video looking at Ocrevus and immunity related to COVID-19: czcams.com/video/7lMPrMUdPZM/video.html
Hi Dr Beaber, I’m an older (57) patient with progressive ms. I do not have relapses any longer but just seem to be on a slow decline. I’m not currently taking a medication but recently became interested in Kesimpta because I could do a self injection. The last drug I was on was Copaxone. I have been off that for about 4 years. Do you think a medication like kesimpta could help a patient like me? I’m pretty sure I’m at the spms stage.
Thank you Dr , I’m getting very close to make a decision, I need to have some test before it gets prescribe. 👍
Blood test !
best of luck to you Hugo :)
Dr. Beaber, I have two questions for ya. So, first how does Kesimpta stack up against Rituxan? It is hard to find information on Kesimpta compared to Ocrevus obviously with Ocrevus being an older drug. Does the data on these two look any similar? Is there any situation where you would see Rituxan being a top choice over Kesimpta?
And, then my second question, what is the advantage or disadvantage of choosing a drug like a b-cell killer over something that impacts both t-cell and b-cells like Lemtrada? Which one would have the potential to better already accrued disability? Thank you! :D
Thank you for this informative video. If I need something stronger then my current medicine (Copaxone) I would go for ocrevus. It seems to work just that little better in the more important outcomes.
I like Ocrevus, best. New clinical trials are studying higher doses of the drug. And I respect Roche/Genentech for trailing their product in PPMS, also.
I also once read Novartis had been involved in a controversy in relation to clinical trial results. Maybe it’s just rumors, but wouldn’t like that...
I finally decided to youtube some stuff about MS and I stumbled across your channel which I'm very happy about. I'm a type 1 diabetic (Diagnosed at 17) and now have remitting MS. I pretty much knew I had MS because of my symptoms a few months before diagnoses just from looking it up online but I had a question I'm a bit nervous to ask someone in real life so figured it would be a bit easier here. I'm 21 now and I've always cared about financials since I was around 15 and wanted to know if it's even worth risking my money in a retirement fund or just to max out my tfsa and then personal or another account? Sorry for such a strange question
I'm probably not the best person to give you financial advice, but generally speaking, young people with a lot of working years ahead of them are advised to invest primarily in equities (ownership positions i.e. stocks and real estate). This is after you have saved up a 6-month emergency fund.
@@DrBrandonBeaber Oh sorry I should have been more clear. I'm in stocks, etfs and some REIT's but there is an account called an RRSP which is better for saving for retirement the only issue is if you take it out before you're 59 and a half you get penalized. So basically with type 1 diabetes and MS is it better to not wait till I'm 59 and a half would you think? It wasn't meant to be too financial more so just someone with a better guess on how people with both usually end up at that age
@@bjungle9809 Anyone can become disabled prior to age 59.5, but I believe generally speaking, there is an exception to the 10% early distribution penalty penalty for people who are disabled. You would have to talk to an expert about this.
@@DrBrandonBeaber Alright thank you so much for answering an abnormal question and thanks for all the videos you make it definitely helps me to know more about my MS :)
I have been on Ocrevus for two years and I having my second relapse. My lymphocytes are back to normal at the six month mark. Went to five month dosing and they are at 48 at five months and I am having a relapse post 1.5 months post infusion. Do you think Kimsemptra would control the B cell count more effectively due to more frequent dosing?
Dear Dr Beaber,
Thanks for the very informativ Video! Could this mean higher Dose cd20 as ocrevus has more effect regarding smoldering ms than low Dose cd20 as Kesimpta ?
Br
I just finished two years of (Mavenclad) in June and my doctor can’t get me in for an MRI until July 2023 to find out if it actually worked. My doctor and I have discussed putting me on Kesimpta or ocrevus asap and my main concern about both of these is PML. I’m JC positive and I’m scared I won’t recognize the symptoms of PML because these are the things I deal with every day.
Same here what did u end up doing? I been going in circles deciding.
This has been my exact same concern when trying to choose an MS medication. I’ve already been on Tecfidera (horrible side effects for me), Avonex (worked for 3 yrs, then new lesion in spine). Now neuro wants me to start Mavenclad. So now I have to figure out if I want to risk cancer or risk PML. I wouldn’t know if I had PML, as on a daily basis, I already experience a good number of the “warning signs” for PML.
Do you have a side by side comparison printout?
I’m wondering about the cost between these two drugs.. Is O cheaper bc only two infusions per year vs. k which is dosed monthly and is newer? Do you have any data about this?
I unfortunately don't have any information on this, and it may vary depending on health insurance and region.
can you tell me if hair loss is associated with either drug, and if so, for which one is the hair loss less?
I have a larger BMI. I was diagnosed with RRMS in 2020 and began Ocrevus. In 2020 I had a relapse and new enhanced lesion. I also have very minimal Igg and igm from Ocrevus. Mr. Dr. Just switched me to Kiesempta hoping it will be more effective being spread out monthly rather than the higher dose then lowering before the next dose. In addition she seems to think it may have less effects on my Igg and Igm. Would love to know your opinion
I can't you personal advice here.
Hi Dr Beaber, I had been using Rebif since my first attack for 8 years. Until now, no new attacks, no new lesions. In my recent MRI, it showed a new lesion and increase in one of the previous lesions, but no attack. My neurologist suggested to pick between Ocrevus, Kesimpta and Mavenclad. Thank you for the video for comparing the first two, I think I’m more attracted to Kesimpta rather than Ocrevus, but I’m also wondering how would you compare these two with Mavenclad. I’m 29yo female. Also, not my priority for the moment but, I’m concerned about pregnancy related things, as well. Looking forward to your suggestions!
I have a video on cladribine for MS if it helps: czcams.com/video/omb32XFK4bQ/video.html
@@DrBrandonBeaber Thanks!
Are the cases of breast cancer in ocrevus have a certain age range? Is it more older patients getting it?
I SWORE I was being overdosed when I first started Ocrevus March 2021, but my neuro said no. I took the infusion a second time and ended up in the hospital for a week and ultimately an electric wheelchair. I’m 5’3” and 100lbs. I just took my first dose of Kesimpta yesterday, and I’m excited about the lower dosage, but I can’t help but wonder if any of my disability has a chance to improve now that I’m not being bombarded with that 6 month infusion.
So which one is better for a person that has ms but is still not at a late stage like tecfidera is relatively safe but messes my stomach up they went up to gylenia but the Sid effects are worst than my simptoms which is less aggressive out of these two shots
Hey Doc I’m wondering what you think would be potentially better for someone who has MS relapsing remitting and lupus and RA? I was just diagnosed with MS and I am in quite a pickle I live in Los Angeles
I can't give you medical advice here, but rituximab has been used in rheumatoid arthritis and lupus for many years, so both ocrevus and kesimpta would likely benefit both of these conditions as well.
What you think about switching from tecfidera to kesimpta. Can you compre those two ? Which is more effective ? I assume kesimpta is better but how big is this diffrence ?
I believe kesimpta is significantly more effective than tecfidera overall, but I can't give you personal advice.
Dr. Beaber why aren't they ever showing lesions in the C-Spine with a MRI. In my case with Progressive MS there are more lesions in my C-Spine that effect my walking than on the brain. There has been no progression of disease since being on Ocrevus. My point is you never hear too much discussed about C-Spine lesions.
For clinical trials, they do brain MRI because they are more likely to find new/enhancing lesions in the brain compared to the spine. Also, new lesions in the brain and much more likely to be asymptomatic. However, spinal cord lesions and spinal cord atrophy may be more associated with motor disability in MS.
@@DrBrandonBeaber Exactly my legs are always stiff and very heavy. I'm doing Botox injections in the legs next Tuesday 560 units to see if it will loosen up.
@@mikerenda3132 I hope it works well for you.
@@DrBrandonBeaber Thank you
I've been on Kisempta for 2 months now and I have been experiencing the worst cramps and numbness in my feet....any suggestions
I will try Kesimpta
Is Ofatumumabe to LLC, isn't? When started to using it for MS? do you know?
From the product label: subcutaneous kesimpta
Initial U.S. Approval: 2009 (for chronic lymphocytic leukemia). For MS, it was 2020
I want this stuff! ... Doctors did want me to change to Ocrevus, but I haven't managed to, yet. Since I need to take care of some stuff first (vaccination against polio, rubella which I had but that was 45 years ago, covid-19), I might as well wait for half a year more, I guess.
I'm on Tecfidera right now, have been for over 10 years.
How has tecfidera worked for you?
Dear Dr Brandon
Thank you so much for this video. Unfortunately I diagnosed too late for MS. Last summer I was in relapsing-remitting stage but no medication, from Feb 2024 I have got severe symptoms and burning every night now they said I am in secondary progress and now they advised me B-cell, kesmpta or Cladribine treatment. I do not like Cladi treatment.
is the kesmpta injection beneficial for progress MS?
Many Thanks
Hi Dr. Beaber, Did you mean Kesimpta is looking to be more under-dosed in general, compared to Ocrevus, or particularly moreso when given high BMI? Does the method of delivery impact on this question?
Not specifically the method of delivery. There was an actual dose finding study with kesimpta, and they chose the lowest dose which suppressed gad+ lesions (but this may be underdosed with respect to suppressing disability progression). I didn't mean anything in terms of BMI, but both ocrevus and kesimpta could be less effective with higher BMI (unproven).
@@DrBrandonBeaber Thank you :)! Would Kesimpta be more quickly taken into lymph nodes and might that itself make it more available where needed in a bigger body?Sorry for the extended question, appreciate your time :)
@@andrewkaldas3337 I don't think so because the volume of distribution would still be larger. If the "BMI phenomenon" exists, it probably exists with all b-cell depleters.
Going to try Kesempta newly diagnosed however most of my lesions are in the thoracic
In 3mos.time I developed more lesions only been on copaxone 2 mos.
Could it be that those with a higher BMI have more progression due to lesser exercise and activity?
This is possible, but although elevated BMI has been identified as a possible risk factor in MS (especially pediatric MS), it's not strongly associated with progression in other trials.
Are you never going to cover zeposia ? What’s going on
I had a reaction to Ocrevus where my blood pressure dropped and kept getting an allergic reaction such as itchy throat. Has there been any reactions of note for Kesimpta like this?
From the published data so far, serious allergic reactions are uncommon with Kesimpta.
Thank you so much!! Today my MS centre proposed me to switch Ocrevus to Kesimpta for the only reason that Is more Easy to handle by the fact that i can do It by myself at home. I love Ocrevus because i had a great experience with that... No side effects and the MS Is stopped... Do you think Is a good idea the switch or Is Better to go on with Ocrevus waiting for more trials in a greater amount of people? Thank you so much
I can't give you personal advice, but I think the two medications are comparable in efficacy
@@DrBrandonBeaber thank you so much, i really appreciate It! A last question if it Is possible for you to answer... But if Ocrevus did work for me, It Is reasonable to think ( given the fact that the Two drugs have the same mechanism ) that also Kesimpta Will work?
Training with rituximab, is there a risk of total loss of hair, eyelashes and eyebrows? Thank you!
Generally speaking, hair loss is not a typical side effect of b-cell depleters like ocrevus, kesimpta, and rituximab.
Why do patients get Benadryl before ocrevus but nothing before kesimpta? Is there more allergic reaction with ocrevus?
Kesimpta is released more slowly into the body. In theory kesimpa is less immunogenic because it is a fully humanized monoclonal antibody, but this is probably not the main factor.
Why not try to use two diffrent drugs with diffrent mechanism at the same time. For example tecfidera and ocrevus together. I undersrand that side effects can cumulate. But maybe it will be ok. And perhabs efficiency and safty will be better then most effective but danger drugs(lemtrada or tysabri) . Is there some research about that?
There is only one such trial called the Combi Rx trial which combined avonex and copaxone vs. each agent individually. There was no benefit to the combination over copaxone alone. n.neurology.org/content/78/1_Supplement/PL02.003
I have only ever received Ocrevous for my PPMS. I very much like the idea of being able to give yourself a monthly dose rather than having a 6 month dosage That being said I have not been 100% satisfied with Ocrevous. I have gone from using a cane ocasionally to using a cane regularly or even using a walker or wheelchair. I thankfully have not had any new lesions.
Tysabri isn’t working for me. My doctor wants to wean me off and start Kesimta. Good idea or no?
Unfortunately, I can't give you medical advice here.
What about the PML risk with Kesimpta
There are no reported cases to my knowledge, but I presume there is a very low risk on the order of < 1:25,000 (assuming no other risk factors) as with ocrevus and rituximab.
Dr. Beaber thank you for this. I was looking for someone to compare these two. Do you have any data or anecdotal clinical observations in your patients on if kesimpta eliminates the supposed “crap gap” in the final month before the next infusion of ocrevus since kesimpta is more frequently dosed? Or could kesimpta have a “wear off period” in week 4 between monthly injections?
I was getting the crap gap the month before my next infusion so I got my Neuro to move the infusion up 2 weeks. I wanted a month but he’d only budge to 2 weeks. It has definitely helped.
What about tall people getting Ocrevus? That don’t necessarily have a high BMI but may weigh more than the average height person? Wouldn’t they also need a higher dose?
In theory yes, but for some reason they chose to study BMI rather than overall weight. I'm not exactly sure why. Again, this topic is still being studied. It is possible this was a spurious result.
Your height and weight are compared to get your BMI. A taller person is going to have more nerve tissue/bone marrow so logically it makes sense to have a higher dose. I'm not a dr, but I have played one as a child. Surgury was difficult. Haha
I was on Ocrevus for 3 years, but I'm in the process of switching to Kesimpta for convenience reasons, I see them as comparatively similar
So am I! Have you made the switch yet?
@@jasminraja9810 looks like I'll be switching to Lemtrada since even on Ocrevus, my brain showed that it was experiencing inflammation even though there was no activity as far as lesions go.
About to start a clinical trail for people who switch from ocrevus to keseimpta wish me luck
Any update? Also why did you switch? I’m torn between ocrevus and kesimpta. I’ve been on Glatiramer Acetate for 4 years and am trying to switch
@@AllThingsHouseplants I would take Keseimpta because Ocrevus for would wear off after 4 months and my cd count would show activity which means i only got 8 months of coverage so with Keseimpta it's every month and as effective as Ocrevus my Cd levels are at 0 and I feel better
@@hamshank8892 great thank you! Any side effects ?
@@AllThingsHouseplants yep just a headache and confusion sometimes but beats going to and infusion clinic
Do you know if Medicare pays for Ocrevus?
I am not sure
Question...when you mention superficial fungal infections as a potential reaction; what sorts of infections are you eluding to?
Athletes foot, jock itch, thrush, et cetera