TagOcrelizumab

#ECTRIMS2021: ocrelizumab the game-changer

Barts-MS rose-tinted-odometer: ★★★★★★★ The first  7-star ‘Teal Blue Monday’ #367588 The next in the series of #ECTRIMS2021 long-term follow-up posts. This is the 7.5 year follow-up of the ocrelizumab OPERA 1&2 (relapsing MS) cohort. The efficacy data looks very impressive.  Annualised relapse rates well below one in 10 years or 0.1 p.a. 2. 82% of ocrelizumab treated subjects had...

Clash of the Titans: the HILO study

Barts-MS rose-tinted-odometer: ★★★ (I am seeing blue and Spanish yellow today) Roche blue (#0066CC) & Novartis Spanish Yellow (#F7B516) Yes, I really do think that intrathecal (within the meninges that cover the brain and spinal cord) or CNS resident B-cells and plasma cells are pathogenic in MS. In other words, the cytokine or chemicals B-cells and plasma cells produce, in particular their...

Smouldering MS – not all bad news

Barts-MS rose-tinted-odometer: ★★★★★ (today’s colour is Delta Red Iron Oxide #9b2f1c) One of the smouldering MS dogmas that have entered the MS lexicon is that the iron-rimmed slowly expanding MS lesions (SELs) go on enlarging and destroying or shredding the brain tissue around it forever. Another dogma states these SELs don’t respond to current DMTs. The good news is that both of these...

Infection risk secondary neutropenia with ocrelizumab

All drugs have a range of predictable side effects. In the case of immunosuppressants/immune depleting agents this is a low white cell count, which increases the risk of infection in the short- or long-term. Ocrelizumab is a monoclonal anti-B-cell (anti-CD20) treatment that specifically targets B-cells, but it may also have what we in the business call off target effects on other immune cells...

How many ofatumumab doses should I miss?

Barts-MS rose-tinted-odometer: ★★★ (It feels like a sky blue rainy Friday =  #87ceeb) “Prof G how many of my monthly ofatumumab injections should I miss to guarantee that I will have an adequate antibody response to the COVID-19 vaccine?” This was the gist of one of the direct messages I received on Twitter from a person with MS living in the US.  I really don’t know...

#MSCOVID19: Cladribine 3 vs. Ocrelizumab 1 vs. Fingolimod 0

Barts-MS rose-tinted-odometer: ★★★★★ Finally, the early Israeli COVID-19 vaccine seroconversion rates are out as a peer-reviewed publication. This data is not new but comes with being vetted by the scientific community and hence can be quoted and discussed at scientific meetings. Protective humoral immunity was 97.9% in healthy subjects, 100% untreated pwMS, 100% in cladribine-treated pwMS, 22.7%...

Guest-post from an ocrelizumaber

I uploaded a video to theMSguide.com a few days ago talking about my concerns as an ocrelizumab patient and how the potential lack of Covid vaccine response stood to impact my life. I am five full infusions into this DMT and the fact that it appears to severely impact the ability to generate a meaningful immune response after a Covid-19 jab is administered is no fault of anybody or anything. It...

#MSCOVID19: T-cell response on ocrelizumab

Barts-MS rose-tinted-odometer: ★★★★★ As you know the vast majority of pwMS on anti-CD20 therapy who get COVID-19 or for that matter any other viral infection recover. In other words, their immune systems work despite blunted or absent B-cell or antibody responses. This study presented yesterday at the AAN meeting confirms that ocrelizumab-treated patients who get COVID-19 have good robust T-cell...

Should we abandon the ADIOS study?

Barts-MS rose-tinted-odometer: ★★★ If you have been on ocrelizumab for two years would you be prepared to participate in the ADIOS (adaptive dosing ocrelizumab study)? One of the study arms would mean that you would not receive any ocrelizumab until you had a relapse or new MRI activity. In other words, we would be using ocrelizumab like we use alemtuzumab or cladribine, i.e. as an immune...

Food for thought

The gastrointestinal tract (image taken from The Conversation) You may not think much of your gut, which in most peoples mind is simply one giant hosepipe from start to finish. But, this week after eating something quite oily, I was painfully made aware of my gut’s existence. The gut from an energy and metabolic point of view is a very important organ, and without it you would simply be a...

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