The Best Multiple Sclerosis Medication!
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- čas přidán 2. 06. 2024
- 2:11 Rebif vs. Avonex
3:17 Betaseron vs. Avonex
3:54 Rebif 44mcg vs. Rebif 22cmg
4:30 Copaxone vs. Avonex
6:05 Copaxone vs Betaseron & Copaxone vs. Rebif
6:41 Gilenya vs. Avonex
8:23 Zeposia (ozanimod) vs. Avonex
9:00 Tecfidera Vs. Copaxone
10:22 Aubagio vs. Rebif
11:18 Imuran Vs. Avonex
12:16 Imuran vs. IFN
12:55 Tysabri vs. Avonex
14:53 Rebif + steroids
16:04 Laquinimod vs. Avonex
16:53 HSCT vs. Novantrone
19:01 HSCT vs. other DMTs
21:06 Lemtrada vs. Rebif
22:24 methotrexate vs. Avonex
23:16 Ocrevus vs. Rebif
24:28 Mavenclad (cladribine) vs. IFN
25:25 Ofatumumab vs. Aubagio
27:43 FINAL RANKING
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
Sources:
HSCT review: www.ncbi.nlm.nih.gov/pmc/arti...
ASCLEPIOS: onlinelibrary.ectrims-congres...
Barry Singer’s post: / 1172489071903379461
OPERA: www.nejm.org/doi/full/10.1056...
Placebo controlled cladribine study (Clarity): www.nejm.org/doi/full/10.1056...
The ONWARD (Oral Cladribine Added ON To Interferon beta-1a in Patients With Active Relapsing Disease): [phase II] nn.neurology.org/content/5/5/...
Lemtrada vs. Rebif: (product label of Lemtrada, page 7) products.sanofi.us/Lemtrada/Le...
Ozanimod vs. avonex: www.ncbi.nlm.nih.gov/pubmed/2...
www.ncbi.nlm.nih.gov/pubmed/3...
• 1) An examination of the results of the EVIDENCE, INCOMIN, and phase III studies of interferon beta products in the treatment of multiple sclerosis ; Timothy Vartanian, MD, PhD; Clinical Therapeutics Volume 25, Issue 1, January 2003, Pages 105-118
• 2) Comparison of interferon beta products and azathioprine in the treatment of relapsing-remitting multiple sclerosis; M. Etemadifar,; Prof. M. Janghorbani,; V. Shaygannejad ; Journal of Neurology ; December 2007, Volume 254, Issue 12, pp 1723-1728
• 3) Non-Inferiority of Azathioprine Versus Beta Interferons for Relapsing-Remitting Multiple Sclerosis Patients: A Multicentric Randomized Trial (Main Trial). Abstract P460
• 4) Drug Class Review: Disease-modifying Drugs for Multiple Sclerosis; Final Update 1 Report
• Drug Class Reviews; Beth Smith, DO, Susan Carson, MPH, Rochelle Fu, PhD, Marian McDonagh, PharmD, Tracy Dana, MLS, Benjamin KS Chan, MS, Sujata Thakurta, MPA-HA, and Andrew Gibler, PharmD.; Portland (OR): Oregon Health & Science University; August 2010.
• 5) Editorial found here: www.msforum.net/Site/ViewPDF/V...
• 6) J Neurol. 2014 Feb 18. [Epub ahead of print] A randomized placebo-controlled phase III trial of oral laquinimod for multiple sclerosis. Vollmer TL1, www.ncbi.nlm.nih.gov/pubmed/24...
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.
Follow me on twitter: / brandon_beaber
Music: INNER GRACE - Copyright 2018 Wilton Vought Source: Really Really Free Music Link: • Video T
he 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
The ONWARD study is not comparing cladribine with inf-b, but the comparison is cladribine+inf-b vs placebo+inf-b. Please correct with a pinned comment. Thank you
This is correct.
What's the best medicine for Ms available?
I have MS and I was diagnosed at 15, I was first put on tecfidera, but relapsed on that. then went on tysabri, relapsed on that, then tried rebif and I relapsed on that too. then my neurologist put me on Ocrevus and I love it, I have stayed in remission for 4+ years with this medication.
I'm glad you are doing well Camryn :)
Excellent and Informative video.This may be my favorite thus far. Thank you for taking the time to create this!
Thanks! I actually got a lot of this data from a presentation I gave to my attendings as a fellow. Is there any major head-to-head trial that I left out? I found it incredibly hard to find a definitive source for these trials.
So cool to see the Jedi Masters connecting here!
Ocrevus gang checking in!
Faccs
✔️
Just joined the gang
Thank you for putting this together! Gives sort of a readers digest version for non medical people that find it difficult to make sense of these charts.
Thank you thank you thank you. I feel like you can read my mind. You always make the videos I need to see!!!
More than 20 dmds... we just need a CURE! Sick of this stupid disease
This video is so thorough and clear to understand. Thank you so much for putting this together. It really helps to understand and evaluate my options for treatment.
Very informative content. Thank you also for the index in the description!
:) I figured most people would not watch a 35 minute video.
Thank you for these videos Dr. :)
No problem. Let me know if you have any video suggestions.
@@DrBrandonBeaber I was wondering if there are natural methods to boost Treg cells / lowering B cells (besides DMTs) / increasing autophagy (through methods such as fasting) & if these can help slow down MS - your video on FMD was great! Definitely would love to see more research on that as it is something patients can control. I also think diet / taking proper supplements at least allows the body the best chance to deal with exogenous/indigenous stresses. I saw there were mice studies that showed a significant drop in B/T cells with 36 hr fasting (but for humans compensating for metabolism *7 that would be about 10 days...). Research was called "Fasting-Refeeding Impacts Immune Cell Dynamics and Mucosal Immune Responses".
Awesome summary! Good idea on the timestamps. 😊
I figured people would want to skip to the drug they are taking/considering.
I’m posting your CZcams channel in a support group- excellent information.
Thanks Desire
I’m trying to streamline things. And you’re always good for education , and occasionally a song 🎵 🤘🏻🤣💪🏻 thank you 🙏🏻 from all of us who have MS- or like your singing 🤷🏻♀️🎵
Wonderful video, amazing! Thank you for taking this effort. I wish I had this information 2 years ago when I was diagnosed and my neurologist sent me home with a list of DMTs to choose from. 'They all work about equally well' and that was it. I felt so lost. I have now met my match but will def refer newly dx'ed pwMS to this vid 🙏❤️
:) I am actually old enough to remember that style of practice. Neurologists had the perception that Avonex/Betaseron/Copaxone/Rebif were all the same (which is actually not true as you can tell from the video).
1 like would not justify the amount of hard work that must have gone into making this comprehensive video. A thank you would do no justice either, but....
Thanks a mil sir for bringing out such videos for us. 🙂
I'm glad it was helpful. I originally compiled these articles for a lecture I gave as a fellow many years ago.
Love the info. Thank you Dr.
You're very welcome
Excellent video!! Best I've seen.
PS I ended year 2 of cladribine 5 weeks back.
My first MS attack was in 1986
Thanks.
Thank you Dr Beaber much appreciate your time putting this together- very interesting!
I'm glad you enjoyed it. There unfortunately aren't a lot of head-to-head trials for multiple sclerosis drugs in modern times.
Yes interesting that - it’s almost like the drug companies don’t want to make it easy to compare on a head to head basis!
@@lemonpeelangelfish This type of study would be very expensive, and drug companies have little motivation to do them unless they are certain their drug will come out a winner.
Echoing all others to thank you for the painstaking work that went into cross-referencing all these studies!
Thought I was clear of all this comparison once my neuro prescribed kesimpta, but looks like I may run up against some step treatment requirements. So this is super helpful in comparing the efficacy of the first-level treatment options of different insurance plans, as my open enrollment looms near.
We're a smallish audience, but your effort makes such a big difference ❤
After about 13 years of MS I tried Rebif and that's when neuropathy started. Without meds I had never experienced pain and the worse part is it didn't work, but I've been in pain ever since.
You’re Awesome doctor it’s been 2y and I remember seeing the video to choose a medication that’s helped me a lot ♥️♥️♥️ keep going 👍🏻♥️
Thanks
Just wanted to say Thank you for doing this and all your other videos for the MS community!!
I'm glad you enjoy them. Let me know if you have a video suggestion.
This ranking definitely mirrors my treatment experience. I’ve only tried Tysabri, Gilenya, Techfidera and Rebif, but I would certainly rate their effectiveness in that order 😁
What about Oceaves?
I was diagnosed in 1999, started on Betaseron and took that until 2011. I had a few relapses and multiple new lesions in that decade. Started on Gilenya in 2011, by 2013 no new lesions and my symptoms stabilized. In 2021, during my yearly physical, my doctor found I developed junctional heart rhythm so I stopped Gilenya. I was told it had caused the heart rhythm. Had to have a ton of cardiac tests to make sure the junctional heart rhythm went away, and it did stay gone. Doc started me on Aubagio and 11 months later with zero MRI progression, I had a whopper of a relapse. I was told it may be rebound after stopping Gilenya. So I got a 3 day solumedrol and I moved on to Ocrevus in October 2022. I've been working to get back to where I was in July 2022 before it all fell apart but I think I have lost some ground for good. And being diagnosed with invasive breast cancer last month hasn't helped.
Hi Dr. Beaber,
First, thank you for making these videos. They are extremely helpful, espeically with such a... confusing disease.
I'm a 29 year old male, I was diagnosed a.1.5 years ago. Within 6 months of diagnosis I was going through round 1 of lemtrada. Unfortunately, after day 2 I started experiencing lung swelling and bleeding, which put me in the hopsital (it took the hospital almost a week to figure out it was lemtrada, despite me telling them when I got there.. they almost did a bronchoscopy because they were conviced it was vape lung disease, smh..). With that in mind, I am of course not allowe to continue with lemtrada, and it has been almost a year since I have been on any DMTs.
I have been looking at zeposia. I know you speak about it here, but I'm curious if you have any thoughts about someone in my situation?
Great video
Thanks.
Hello Dr. Beaber,
Thank you for taking the time to prepare these videos, you have no idea how helpful it is for me and anyone else struggling with MS!
I am 27 years old and was diagnosed with Relapsing Remitting Multiple Sclerosis 1 year ago and have been taking avonex/cinnovex for 9 about months. Unfortunately, the new MRI showed 6 new lesions in the brain (1 of them is currently active) and spinal cord (i am no longer surprised that Interferon_beta-1a did not work for me after seeing the numbers and comparison in your presentation)
I live in lebanon, and we are currently going through major shortage in all medications. I have the choice to switch to Tysabri or mabthera (generic for rituximab) - tecfidera is also available.
Do you have any recommendation?
Thank you for your time.
I'm glad the video was helpful, but I can't give you specific medical advice here. Both Tysabri and mabthera are considered to be high-efficacy disease modifying therapies. Many people make this type of decision based on concerns about lifestyle and side effects. For someone planning to become pregnant or who has unstable health insurance, tysabri isn't a great option (risk of post-tysabri rebound)
Outstanding ❤
Thanks. Maybe I should make an update to this video.
Hi Dr. Brandon Beaber, could you make a video directly comparing Aubagio (Teriflunomide) to Betaseron (Interferon beta-1b) and also comment on any information regarding their differing efficacy (disease progression & lesions) with patients having high BMI (if applicable)?
There is a clinical trial called the TENERE study which compared Aubagio with Rebif (which is similar in efficacy to Betaseron) suggesting they are approximately equally effective: journals.sagepub.com/doi/full/10.1177/1352458513507821 I am not aware on any specific data on how BMI would effect these drugs.
Thank you for posting this video! I've been on the edge of which medication to switch to since I've grown tiresome and it's been traumatic injecting copaxone into my body for 5 years. I've been wanting to switch to an oral medication but every time I look at them, they always say that the side effect of an oral medication is a low blood count. Is that common or rare in your patients or from a research point of view?
I depends on the exact medication. For gilenya (and other S1P modulators such as ozanimod, siponimod), a low lymphocyte count is a normal side effect. For Tecifdera (and vumerity, bafiertam), low lymphocytes occur in some but not all. Most people taking aubagio have normal white blood cell counts.
I took Avonex for 4 months and absolutely hated it. I felt pretty bad every day except for Thursday and then it all began again on Friday (injection day). I pretty much had no life on that medication and stopped taking it.
Thank you so much for this collection! Do you also have information on Plegidry? Perhaps it has just another name in your list?
Plegridy is similar in efficacy to avonex.
@@DrBrandonBeaber Thanks! Do you have a reference for that? I was told it was similar to Rebif.
@@yeahruud588 There is no head to head trial against either avonex or rebif, so I can't say for sure.
It is unfortunate that HCST is not more available even though research shows it is effective. Do you see this changing anytime soon? Thanks for this informative video!
I think it's unlikely. Doctors tend to be extremely risk adverse, and most hematologists want nothing to do with treating autoimmune disease. If there were a head to head trial showing a clear benefit of HSCT over high-efficacy drugs such as rituxan/tysabri/ocrevus/Lemtrada, it might be different, but who would fund such a trial? Also, some people could enroll in the trial and then drop out once they are not assigned to HSCT.
@@DrBrandonBeaber Thank you for your response and for your dedication to the MS community!
@@DrBrandonBeaber the trial I was in was randomized- participants were told if they were randomized to control drug that if/when the drug failed they would switch over to HSCT arm. Of course the study ended before everyone had a chance to switch over.
I had HSCT done at ClinicaRuiz in Puebla Mexico. Top notch facilities. As good or better than US. It didn’t cure me, but others in my group say they have stopped progressing. Biggest benefit was meeting and experiencing this with others with MS. Also, introduced me to Rituxan, which seems to slow my progression. Recommended if you can afford it.
Wow, I will be having my 3rd MRI to obtain the official diagnosis according to the neurologist, I am a 54 year old woman, fit, active, no illnesses whatsoever, . , I am 108 lbs. will I survive the side effects?
Great information, I am very grateful for all your efforts.
For most multiple sclerosis disease modifying therapies, the dosing is not weight-based, and being a 108 lbs would not be a problem.
Hi Dr. Beaber. I was wondering what you thought about Chlamydia pneumoniae causing multiple sclerosis?
Can you go over what the most effective treatment would be for MS patients with severe psoriasis?
Hi Dr Beaber, would you say that Copaxone is the safest therapy with high jcv titer levels like over 2.5? And would you then recommend the daily or every other day injections for efficacy? Thank you great video
There are no known cases of glatiramer (copaxone/glatopa) associated PML, so I don't believe there is any association between PML and this medication, though this is true for several other MS disease modifying therapies. I have no strong opinion about the 20mg daily dose vs. the 40mg three times weekly regimen.
@@DrBrandonBeaber thank you so much I feel the same about the risk with Copaxone. I feel that my body handled the daily injections better but didn't like doing it daily..lol I really appreciate your time.
@@1feralleo I can certainly understand this as I have tried it myself! czcams.com/video/wvoXFGFwUR4/video.html
Upon diagnosis about 13 years ago, I was infused with twice daily heavy doses of Solumedrol and then weaned off of an oral steroid.
The experience led to vowing to never repeat the treatment as it was marked by ruthless side effects.
I was wondering if you would consider making a video detailing corticosteroids and MS. Is it still used and if so, how is it effective?
I know that Solumedrol comes with Ocrevus and is probably responsible for that sleepless night I have grown used to on treatment day.
Thanks for the suggestion. I'll make a note of it (I have some other videos I am planning to do first)
Wow, an MS specialist I agree with.
I have PPMS or SPMS depending on my doctor and what drug he wants me on.
I have had HSCT at clinica Ruiz. I’ve also been on Copaxon, Gilenya and Rituxan.
Difficult to separate HSCT and Rituxan because Rituxan was a part of my HSCT program.
Copaxon and Gilenya had no effect.
I endured HSCT no problem, but it was not a cure for me. Rituxan seems to slow my progression, but have not had an infusion for almost a year due to COVID.
So my experience was pretty much in line with Dr. Beaber.
Thanks for sharing your experience.
Just had an upsetting remote consult with my MS specialist. He does not recommend continuing Rituxan because the MS Society found that 6 of 93 people on Rituxan that got COVID have died and that he didn’t think Rituxan worked. He also wants me to be part of a phase 3 trial by Roche for Fenebrutinib? I feel totally lost now. I’m not sure that Rituxan helped me, but believe it’s the only DMD that didn’t hurt me. I don’t trust Roche because of the Ocrevus/Rituxan scam. I’m on the cusp of losing my ability to walk and don’t know what to do next.
@@quigonjin6030 :( Sorry to hear you are in a difficult spot. Things are very complicated with the COVID-19 pandemic. I wish you the best of luck.
I would like to get #1 prescribed as I highly agree that it is the best option in terms of efficacy over a short term and over a long term without additional treatment or perhaps a repeat treatment every few years. I can't afford it out of pocket though. I responded surprisingly well to IVIG but I recognize it's not often very effective in MS over a population. Is it possible that IVIG could partially reprogram or alter a faulty immune system in very unusual cases?
It's hard for me to answer this, but I am skeptical that IVIG has any benefit to anyone with MS (aside from treatment of hypogammaglobulinemia in people taking b-cell depleters to prevent infections).
Hello Dr. Brandon Beaber, my neurologist is thinking I am in the secondary progressive phase, and I am considering siponimod for treatment but I have the jc virus and don't want PML. Have there been cases of PML with Siponimod, or else in Ocrevus? Year after year I am less able to continue walking, now past 10 min I have to sit down. Without distinct new evidence for relapse on a scan, I am avoiding more gad enhancing MRI because of the associated risks of doing this more than once. History wise I have been on Betaseron, switched to Aubagio, and am trying to work out what to do. Please let me know if there is any info I can provide to help you to recall what would be good for me to know. Thank you.
I'm not sure about reported cases of PML with siponimod, but there is likely a very small risk (~20,000:1 with the similar medication gilenya). I am aware of only a single case of PML in someone taking ocrevus who had not previously received tysabri.
Dear Dr., is there a new update in your Ranking ? Do you think Cladribin Had Shown some advantages in comparison to anti cd20 Therapies ? There are some ms experts who recommend bzell depleaters as First line And another expert from the Uk. is more for Cladribin Starting. Thanks for Feedback And best wishes from germany!
Can you do a video on Biotin, the studies they are doing and what they have found so far please? Thank you
I already did one in 2020. Here is the link: czcams.com/video/CS6CWPBHKGM/video.html
Based on this do you recommend HSCT or Alemtuzumab to all your patients?
No. Safety is also a consideration, not just efficacy.
@@DrBrandonBeaber None of these are safe...they all lead to yearly brain loss...and secondary progressive ms and right into an institution.
Goodevening doctor, does tecfidera 120mg twice a day gives almost similar result as tecfidera 240mg, since I'm unable to tolerate 240mg considering hair loss and heartheartburn. Please advise.
To be honest, I am not aware of any specific data on the 120mg twice a day dose.
Has scheman growth hormone ever been studied with MS? I read that it has neuroprotective qualities and also may promote remyelination
Not that I know of, and a quick search doesn't bring anything up.
I have been on Glatect for almost two years now and I have to inject myself daily. I’m looking into changing to a different therapy. What would you recommend? I will be going to see my neurologist to get results from new MRI and I would like to request to change meds.
I can't give you personal advice here, but hopefully this video gave you some ideas to discuss with your neurologist. I wish you the best of luck.
Yes I did. Thanks a lot for a very educated vídeo about the MDT. 🙏🏽
I would love to hear your thoughts on the recent CAR-T study results in mice.
thanks for the suggestion. I would have to look into this. Do you have a reference you would like me to look at?
Is there any way I could show you part of my mri study and you give me your opinion. I have severe emphysema and recently diagnosed with ms but I feel like the brain lesions could be due to 02 loss and severe central sleep apnea.
Unfortunately I can't give you personal advice here
Hello Dr. I’m from the Philippines and i was diagnosed with NMOSD . I want to ask if the itchyness can go away? the left side of my head is really itch . i had this before i was diagnosed. PLEASE RESPOND I NEED AN ANSWER 🙏🙏🙏😭
I recommend to you all Dr Ehimare herbs on CZcams channel that get my husband cured after the usage of herbs medicine treatment from Dr Ehimare on CZcams channel also get in touch with him ❤️
Doesn't Interferon 3 times a week suncutaneously make your liver explode? I currently am on Avonex, only once a week intramuscular, and the day after the injection i have no appetite and sometimes am nauseous.
Most people taking high dose high frequency interferons don't have liver problems, but it is a possible side effect.
@@DrBrandonBeaber Thank you very much!
Hi Dr. Beaber, could you please tell me where you would personally place Kesimpta in your ranking? Which number? Thank you very much.
roughly equal with other b-cell depleters (rituximab, ocrevus).
@@DrBrandonBeaber of these b-cell depleters , may I ask what would you personally reason to guess to be the least likely to lead to PML? I realized we have more data for some drugs than others but because you know how these work I would be interested in what you think are more risky in the aforementioned way.
How do I get an appointment with you. Very unwell and unable to get the help I need.
If you would like a source for one of the articles that is not in the video description, let me know, and I would be happy to reply with a link.
@Nutshell _ Thanks for sharing your story, and I hope you continue to do well.
@Nutshell _ I don't see how familial mediterranean fever could be confused with MS.
Could you please make a comparison Tysabri versus Ocrelizumab? Or if there already is such a video, could you please give me the link? I would immensely appreciate it. I am on Avonex and it is not very effective. My neurologist said i could try Tysabri or Ocrelizumab if i wanted to. Ocrelizumab is basically chemotherapy so chances are very low i would even consider it. But still, i would love a comparison between the two, it would help me make a decision, or not make any decision whatsoever.
@@annaconsta I'm not aware of any study directly comparing these medications. Ocrevus has slightly better data in terms of prevention of gadolinium enhancing lesions, but my personal opinion is that they are about equally effective. I do have separate videos on each of these medications if it would help you. Ocrevus: czcams.com/video/mCVVvq7Aov0/video.html Tysabri: czcams.com/video/LIKPYQFVNCQ/video.html
I would like to know more on the safety profile of aHSCT. The current status in the Netherlands is that aHSCT is denied to MS patients because its too dangerous.
Euthanasia is offered to MS patients tough...
So the dutch patients have to pay/ crowdfund themselves, and go to moscow or mexico for treatment. With no objective discription of the negative dangers....
What is the “best “ oral MS medicine? I’m on tysabri infusion, but I’m trying to find a oral medication
They haven't been compared head-to-head against other oral agents but most likely the s1p receptor modulators (gilenya, ozanimod, mayzent)
I have been on tysabri for13 years, and have just now tested positive for the Jaycee virus, and I’m moving to an oral medication
Do you think that is a long way to approve HSCT as a one of the standard treatment?
HSCT isn't a single treatment, so I don't think it would ever be FDA/EMA approved. HSCT is essentially a class of different treatments which could be described as "immune rebooting therapy." HSCT could become more popular if it could defeat a high-efficacy disease modifying therapy such as Lemtrada in a randomized trial, but I don't know who would fund this trial.
@@DrBrandonBeaber fda only approves food/drugs not procedures..the drug CYC chemo is already fda approved....Lemtrada is 50% effective hsct is 70% at 5 years....people w/low cd8 counts fail hsct at 5 years...those w/ ultra low cd 8 just non-respond at the start... cd 8+ cells control EBV.
Thank you doctor could you do the best drugs 2023 for updates 🙏🏻🙏🏻🙏🏻 please
Thanks for the suggestion. I may do an update to this video
Someone said that you can as multiple Sclerosis patient live without medication just depends on healthy diet and slightly exercise with less stress.. it seems a good idea but kind of afraid to do it!
I do have a playlist on nutrition and MS if you would like to take a look: czcams.com/video/Cey5muWJBs0/video.html
Hi Dr. Brandon Beaber, I was wondering how would this list change if it was specifically for someone who has a BMI of about 40? (5 ft 11" /290lbs) Thank you very much.
It probably wouldn't change much. There is some evidence based on a retrospective analysis that the drug Ocrevus may be less effective in people with a higher body mass index, and this is being researched further.
@Dr. Brandon Beaber Should I still personally consider taking Ocrevus or would another med likely make more sense? Thanks.
@@andrewkaldas3337 I unfortunately can't give you personal medical advice here. I personally would take into account body weight much in making my recommendations.
@@DrBrandonBeaber Understandable, I will ask about the studies mentioned when next I meet my neurologist. Thank you.
@@andrewkaldas3337 Here is the link to the article: www.ncbi.nlm.nih.gov/pmc/articles/PMC6469695/ "significant treatment-by-subgroup interactions for BMI indicate that the magnitude of ocrelizumab treatment benefit is greater in lighter patients versus heavier, consistent with lower ocrelizumab exposure in heavier patients (BMI > 25 kg/m2 versus
Can a patient using gilenya switch to rebif or is gilenya a stronger medication?
My husband is on Extavia for RRMS. Would one of the other meds work better?
I can't give you any direct medical advice here. There are certainly many medications believed to be more effective than extavia, but there are other considerations (safety of the medication, other medical conditions, the specific history of multiple sclerosis, individual preferences).
@@DrBrandonBeaber Thank you.
Hello. Can you compare Copaxone with Aubagio and Tecfidera? Thanks
If you skip to 9:00, I compare Tecfidera Vs. Copaxone. There is no head to head trial with Aubagio except Aubagio vs. Rebif (10:22)
@@DrBrandonBeaber Thanks for the answer. I saw the comparisons you told me, in fact I saw the full video. I would like to know which of the medications (Copaxone, Aubagio, Tecfidera) is the best in your opinion. Thanks
The doctor give me list of medications and told me to choose and i read alot about all meds and I choose to start with tecfidera hope it be helpful for me
I wish you the best of luck.
Why doesn't HSCT work on PPMS? Is the disease purely neurodegenerative at that point, and not autoimmune?
The theory is that systemic inflammation is less important in PPMS and that inflammation within the central nervous system compartment, mitochondrial failure, and other local factors are driving progression. I am going to publish a more detailed video on HSCT shortly. There is a pilot study in progressive MS published in 1997 with BEAM + ATG (median age 37, median EDSS 6) showing a possible modest benefit, but there was extremely poor follow up, limiting interpretation of the data. Here is the link: www.nature.com/articles/1700944.pdf
@@DrBrandonBeaber What? This study is over 20 years old, very positive and then ignored by our scientists? What is wrong with us? Thanks a lot for the link.
@@CFinckelstein I'll show the data in a little bit more detail in the upcoming video. Like I said, there was very high dropout rate, so it is very difficult to tell if there was any benefit to the treatment. Often, people who have better results with an intervention are more likely to come to the follow up visits.
@@DrBrandonBeaber good point. Thanks for reply. And keep on your amazing work
Is it possible if you’re still having trouble on ocrevus that rebif may work better for you?? Thanks
Overall, Ocrevus is more effective than Rebif based on the OPERA I/II studies, but an individual can always have better results on an individual medication.
I know three people on It all with Good reviews
How do you feel about clemastine after AHSCT?
I have a separate video on clemastine: czcams.com/video/T6p5e2TcR9Q/video.html I don't have any specific opinion on using it after aHSCT.
Hi Dr. Beaber, for Active Secondary Progressive MS *specifically* could you please comment on the difference in efficacy (+ risk if time permits) between Ocrevus vs Mayzent?
High dose 50000 to 300000 units of vitamin D are be being used.
Thoughts on Riximyo?
I would not consider it to be the best without considering side effects.
Hey I’m a recent diagnosed ms and I’m choosing what treatment to go for yet I’m thinking mavenclad however I wanna try herbal supplements?
I can't give you any personal advice, but I wish you the best of luck regardless of what you decide
Hi sister,
I am also thinking of mavenclad. Did you start the treatment?
could you share a link to a comparison of Ocrelizumab to Rituximab/Truxima? I wanted to know more about the long term studies of rituximab
I am not aware of any specific trial comparing them, but in Sweden, they have many publications on long-term use of rituximab in MS as in this publication on de-escalation: link.springer.com/article/10.1007/s00415-021-10399-8 ECTRIMS 2019 actually had a debate on this subject (somewhat biased in my opinion): multiplesclerosisnewstoday.com/news-posts/2019/10/04/ectrims2019-is-rituximab-a-reasonable-option-for-ms-patients
Hello, I was on avonex, made my depression horrible, changed neurologist.. she said to stop avonex now, because it’s not good especially for depression. She wants to put me on Tysabri ASAP but I’m terrified of it only because read all the side effects and they are scary, I’m JCV negative. I’m not sure about this medication and wonder if anyone here is on Tysabri infusion? How do you like it, do you see any positive results or negative too. How did the infusion feel, how long are you on it? I’m going crazy to find out more about it. I scheduled another appointment with my doc to talk about it more. I’m confused 🥺. Help please !!
Hi Mirka. I’ve been on Tysabri for 5 years and I have a friend who’s been on it 12 years. Both JC negative and neither of us have clinically progressed since starting. It appears to be quite safe in JC negative people, and, even though risks go up with years of use, if you know the symptoms of PML then you can look out for them. Apart from PML, the risks are less than the other IV treatments (that often carry risks of malignancy along with PML). I truly wish you the best in this decision! 😁
Oh, and as to what it feels like... nothing! It doesn’t feel like anything has happened - no pain, no reactions (although my friend occasionally feels allergy type symptoms that are easily mitigated by concurrent IV antihistamines). I can feel the saline more than the Tysabri because the saline is cold hahaha. Sometimes I feel tired for 24 hours afterwards, but occasionally I am energised. I notice symptoms creeping back in (mainly fatigue) towards the end of every month, so I’m always looking foreword to topping up my tank!
Great. Primary Sjogren has none.
Are you a neurologist
Yes
I'm from India . i have MS please give me zeposia . i want to live my life peacefully
Kesimpta?
This video predates the approval of kesimpta
@@DrBrandonBeaber sorry I was sent this by someone else so I'll ask do you have any video that talks about kesimpta?
@@StrangerOnO Kesimpta (Ofatumumab) for Multiple Sclerosis [ASCLEPIOS I/II trial results]: czcams.com/video/IIBBlvnPjS0/video.html Ocrevus vs. Kesimpta for Multiple Sclerosis. Comparison Between the Drugs, Efficacy, Side Effects: czcams.com/video/BVhN4_sEi1s/video.html
Mm
You lost me at “we are not going to look at side effects” bye ✌️
Do you know where the US is in health care? 37th. I especially like the study from 2017 where we rank 54th. You should be in jail. In the Ukraine they discovered the cure for MS in 1987. Again, you should be in jail.
Jason, I would love to know the cure Ukraine found in 1987. If that's the case I would quit all my meds.
???
@@DrBrandonBeaber You should go to prison.
Jason it is my opinion that have no right saying to Brandon. Between him and Aaron Boster, they are doing everything they can to help those of us impacted by ms.
@@roberture5903 They rank 37th in health care. Again, I like the study from 2017. Follow Dr. Terri Wahls, Dr. George Gelinik (sp?), or Matt Embry. Follow their protocols. If you need further help, go to Clinica Ruiz for HSCT and if you need further, go to EmCell in the Ukraine.
This is telling:
czcams.com/video/i0m_isndqc0/video.html
Again, you should be in jail.
I have so many lesions it’s hard to count at first I got double vision and loss of feeling in hands 8 days of solumedrol I got everything back immediately got on copaxone. 13 years no relapses, hard to believe because of lesions financial reasons stopped taking it and started zaposia been on that now 1 year feel the same nothing has changed except I don’t give shots anymore thank god🙏now just a tiny pill. So in my opinion copaxone and zaposia are number one. I’d like to read others opinions please and thank you.