Are Ocrevus and Rituxan Similar? Neurologists Respond to Patients’ Concerns

Are Ocrevus and Rituxan Similar? Neurologists Respond to Patients’ Concerns

While many multiple sclerosis patients celebrated the recent approval of Ocrevus (ocrelizumab), others argued that the drug is largely a rebranded version of rituximab. Rituximab — sold as Rituxan for indications like non-Hodgkin’s lymphoma, chronic lymphocytic leukemia, and rheumatoid arthritis — is used off-label to treat relapsing MS.

In online forums and social media, claims circulated that this rebranding of an existing drug was a way for Genentech — Ocrevus’ developer — to make more money at the expense of patients.

These claims drew upon the fact that the U.S. patent covering Rituxan will soon expire. This allows other companies to produce so-called biosimilar versions of the drug, which might be marketed at lower costs — a development already taking place outside the U.S.

The debate was further fueled when a former Genentech employee, Dr. Annette Langer-Gould, called Ocrevus a “fake breakthrough” in an interview published in an April 3 blog in HealthNewsReview.

Langer-Gould said that the choice to develop Ocrevus — instead of working to get Rituxan approved for MS — delayed the approval of a highly effective MS treatment for a decade.

So are Rituxan and Ocrevus really the same therapy?

Multiple Sclerosis News Today attempted to clarify this issue — comparing a number of online statements with those given by a neurologist at Genentech, Dr. Peter Chin, and by Dr. Robert Lisak, a neurologist and past president of the Consortium of Multiple Sclerosis Centers (CMSC).

Genentech on Langer-Gould

In a Genentech statement provided to MS News Today, the company acknowledges that Langer-Gould was an employee with insights into the development of Ocrevus while working there — some 10 years ago.

“Dr. Annette Langer-Gould worked at Genentech from September 2006 to September 2007. She had no involvement in the strategic and clinical decisions regarding Ocrevus’ development after she left the company,” the statement read.

At the time, Ocrevus had not yet entered the first Phase 2 trial (NCT00676715) in MS patients. Langer-Gould is now a research scientist with Kaiser Permanente in California, and an MS specialist at Los Angeles Medical Center. She works with a clinic that treats MS patients with Rituxan.

Rituxan is not approved for MS, but it has been used off-label within the U.S. and, particularly, outside the country, where other health insurance regulations may enable the practice.

“We encourage HCPs [healthcare practitioners] to make their own decisions on what’s right for their patient,” Genentech wrote in the statement.

The molecular side of things

Both Ocrevus and Rituxan are drugs that target B-cells that have CD20 molecules on their surface, as critics have pointed out. According to a statement issued by the International Multiple Sclerosis Management Practice (IMSMP), the two drugs “should have almost identical anti-B cell activity.”

At IMSMP/TISCH MS Research Center of New York, physicians have been prescribing Rituxan to MS patients for the past 16 years. The center had persuaded Medicare in New York to cover the off-label drug, using data of its effectivity as an argument. Since it is not an approved MS treatment, most health insurance plans do not cover Rituxan.

Chin, who is group medical director, Neuroscience, at Genentech, said the two therapies have distinct differences.

“Although Ocrevus and Rituxan both target CD20-positive B cells, they are different molecules in their structure and how they interact with the immune system,” Chin said, adding that the two drugs bind overlapping but different epitopes on the CD20 molecule. An epitope is the part of a protein that an antibody recognizes and binds to.

The drugs, subsequently, differ in how efficiently they directly, and indirectly, kill B-cells. Ocrevus has a higher capacity for direct, antibody-dependent, cell toxicity compared to Rituxan. And, Chin added, it has a lower capacity for indirect, complement-mediated cell killing.

The complement system is part of the immune defense, and both Rituxan and Ocrevus activate it as a part of each drug’s cell-killing mechanism.  But Ocrevus — by having a more direct, or controlled, action — may have fewer indirect and damaging effects on the immune system.

Chin also pointed out that while Rituxan is a chimeric antibody, composed of both mouse and human parts, Ocrevus is a humanized molecule. “This important distinction reduces the chance that an MS patient’s immune system may form antibodies against the medicine (known as anti-drug antibodies) and may reduce the chance these anti-drug antibodies will decrease the effectiveness of the medicine over time.”

All biological drugs might be recognized by the immune system as something foreign that needs to be eliminated. So-called neutralizing anti-drug antibodies can render a treatment totally ineffective.

According to the Genentech statement, early studies of Rituxan in MS showed that many patients developed anti-Rituxan antibodies — 28.6% and 24.6% in two trials in relapsing patients, and 7% in a trial with primary progressive MS patients.

In the Ocrevus trials, 0.4 percent of relapsing patients developed antibodies against Ocrevus. Of these, only one had neutralizing antibodies. Among primary progressive Ocrevus-treated participants, 1.9 percent developed anti-drug antibodies. Again, only one person showed antibodies of the neutralizing type.

But while such comparisons can provide an idea of how the two drugs differ, Lisak pointed out that a study which directly compares the drugs is needed to prove whether they differ in efficacy and side effects.

“One can believe or even think that there are no differences between rituximab and ocrelizumab in RRMS [relapsing-remitting MS], you cannot prove there are no differences without a head-to-head study,” he told MS News Today in an email.

Such a study is underway. University of Colorado researchers have launched a clinical trial (NCT02980042) that will explore the safety of switching from Rituxan to Ocrevus, and compare the two therapies for safety and tolerability. Its lead investigator, Dr. Timothy Vollmer, is among those who — “at this time” —  considers the two drugs to be similar. “[I]f either one is more safe or effective … than the other is a discussion,” Vollmer said in an interview. “But there’s no real data.”

Strategy or science?

Genentech has been accused of developing Ocrevus based on commercial considerations. Or, in less flattering words, of cheating patients by developing a new medicine that could bring in more money, instead of expanding the indication of an already approved drug.

According to Genentech, Rituxan was essential to the company proving that B-cells played a role in MS. But Ocrevus, as ocrelizumab, was chosen for development instead of Rituxan, because Ocrevus was better suited to treating a chronic disease like MS.

“At that time, Genentech had a number of anti-CD20 targeted molecules in our portfolio with different features,” the company wrote in the statement. “We advanced ocrelizumab, a humanized anti-CD20 antibody, into late-stage development because we believed it had the best potential efficacy and safety profile for people living with MS, a disease where long-term treatment is warranted.”

Genentech also underscored that drug development is a science-based process.

“As a company, we take a data-driven approach to drug development and bringing new medicines to patients. We stand by all of the information we have provided to the media about Ocrevus as accurate and transparent.”

Part of the Rituxan versus Ocrevus debate has circled around primary progressive MS (PPMS) patients. Early research showed that Rituxan was not effective in this patient group, except for a subset of PPMS patients.

Some argue that this subset made up a large part of the ORATORIO trial (NCT01194570), allowing the company to get Ocrevus approved for progressive MS even though many PPMS patients might not benefit from the treatment.

But, said Lisak, this is a claim that cannot be proven.

“It is possible that ORATORIO treated patients represented some of that same subset but there wasn’t enough power in ORATORIO to definitely prove that theory,” he said.

Too high a dose?

In the HealthNewsReview article, Langer-Gould raised another question about the Ocrevus trial data. She stated that Ocrevus was given to patients at far too high dose, which was not tested adequately.

Chin said that the decision to develop Ocrevus for both relapsing and primary progressive MS at a 600 mg dose was a result of “an evolution of scientific understanding from rigorous controlled clinical trials spanning a decade.”

During the first study of Ocrevus in rheumatoid arthritis (NCT00077870), Genentech tested five doses, ranging from 20 mg to 2,000 mg. Based on this trial’s results, the company started evaluating two doses of Ocrevus in a Phase 2 trial (NCT00676715) of relapsing MS — 600 mg and 2,000 mg.

Chin also underscored that the choice of Ocrevus dose involved regulatory agencies, in addition to Genentech scientists.

“Dose selection for the MS Phase 3 studies was made in consultation with both the FDA and European Medicines Agency,” he said, and added that this dose is effective and safe, as has been demonstrated in three Phase 3 clinical trials.

No other MS physicians or researchers have raised concerns about the dose, so far. When asked about it, Lisak pointed out that for non-cancer diseases treated with Rituxan, researchers do not really know how low the B-cell counts need to be to provide a therapeutic benefit.

He cited results from a study of another CD20-targeting antibody, ofatumumab, which showed that although the lowest doses did not completely deplete B-cells in the peripheral blood stream, they seemed to benefit relapsing MS patients equally well as the higher doses.

But, adding that the trial was only Phase 2, Lisak said: “We don’t know if a higher dose of any of these monoclonal antibodies might matter with regard to meningeal B-cells.”

Meningeal B-cells can be found in the membranes covering the brain.

Is Ocrevus safe?

While reports from clinical trials of Ocrevus stated that the drug was generally safe, with mild-to-moderate infusion reactions and upper respiratory tract infections being the most common side effects, there is one safety aspect of Ocrevus that has caught the public’s eye.

In the three Phase 3 trials, more Ocrevus-treated patients developed cancer than those in the respective control groups. According to Chin, this means that “an increased risk cannot be ruled out.”

This issue has been used as an argument by some who recommend MS patients continue with the older drug, Rituxan, off-label rather than switch. Since Rituxan has been used for a long time, plenty of data exists about its potential side effects.

But Chin pointed out that, although more patients in the Ocrevus groups developed tumors, the numbers were not higher than what is known to occur in studies assessing MS patients in general. And, he added, Genentech does not take these findings lightly.

“Patient safety is very important to us at Genentech and we are committed to conducting long-term post-approval safety studies on Ocrevus,” Chin said. Long-term extension studies of the initial Phase 3 trials that ran for three years, among other studies, are now underway.

But the IMSMP, in its March 31 statement, called the number of cancer-affected patients in the Ocrevus-treated trial groups “alarmingly high” — a stark contrast in wording from Genentech.

The IMSMP also noted that an early trial of Ocrevus in rheumatoid arthritis was cut short when patients developed life-threatening infections.

Although the rates of severe infections were similar in the Ocrevus-treated and respective control groups in the three trials, many neurologists, including Lisak, have underscored that new risks may only become apparent when long-term data become available.

“Although it is, indeed, progress that the first medication for PPMS has been approved, the patients should be fully informed of its’ potential risks,” IMSMP wrote. “For patients who can obtain Rituximab, it would be safer to continue with this therapy, until with time, we are better able to advise patients about the risks associated with Ocrelizumab.

Chin stated that, to date, no increased cancer rates with a longer Ocrevus treatment have been detected in the follow-up extension studies.

The debate about the potential similarities between Rituxan and Ocrevus is likely to continue. Future research into the two drugs, as well as into the science of B-cell depletion in MS in general, are likely to provide answers to many of the concerns raised by patients.

Patrícia holds her PhD in Medical Microbiology and Infectious Diseases from the Leiden University Medical Center in Leiden, The Netherlands. She has studied Applied Biology at Universidade do Minho and was a postdoctoral research fellow at Instituto de Medicina Molecular in Lisbon, Portugal. Her work has been focused on molecular genetic traits of infectious agents such as viruses and parasites.
Patrícia holds her PhD in Medical Microbiology and Infectious Diseases from the Leiden University Medical Center in Leiden, The Netherlands. She has studied Applied Biology at Universidade do Minho and was a postdoctoral research fellow at Instituto de Medicina Molecular in Lisbon, Portugal. Her work has been focused on molecular genetic traits of infectious agents such as viruses and parasites.


  1. Kiyan says:

    So, in sum, the two drugs may only be different in their ‘side effects’ given the possibly more specific cell selection which Ocrevus is purported to show, but the actual efficacy of the two drugs in treating MS of any kind may not be different. We don’t know, because, we don’t yet have the data, and somehow Genentech wants the benefit of the doubt that their decision to not expand the indications for Rituximab was motivated by the data they did have, ignoring the elephant in the room (e.g. The expiry of the patents for Rituximab?)

    In case you believe Genentech, contact me for a bridge I’m selling!

  2. Holly Jones says:

    I wish the article had included discussion of the possible anaphylactic reaction to Ocrevus. I have SPMS & tried Rituxan twice but even after Benadryl and Solumedrol still had an anaphylactic reaction within minutes of the start of the infusion. While I have been anxiously waiting for the approval, I am also cautiously optimistic of my success with Ocrevus.

  3. Regina Alice Schroeder says:

    no, I think that neutralizing antibodies are significantly less likely to occur with Ocrevus could be dispositive. If my neuro does too, I’m switching. Talk to your doctor.

  4. C. Council says:

    I have been taking Rebif for ten years (since the onset of MS) an progressing slowly but much fatigue, which has been somewhat life changing. I am going to go to a new neurologist, after 10 years, and hopefully get some new ideas on whether Ocrevus may be a better treatment for me…..I have also only had one MRI (10 years ago) because no real changes except slow progression — a little more immobility in the last year….(None use cane all the time, and have had a mobility scooter for 4 years for long distance) ….any thoughts would be appreciated !!

    • D Karner says:

      I like data. I’d be livid if my neurologist didn’t demand contrasting MRI’s every 1-2 years. Your neurologist seems more interested in treating your symptoms, not your disease. To me, that approach would be unsatisfactory.

      • Margo Scott says:

        Please be aware the contrast agent they use in MRIs is neurotoxic and causes neurological inflammation. If you’re neuro is not aware of this, and recommends them regularly, they could increase the progression of your MS. Seriously. Be informed. It’s your life these big pharma companies are playing with – they DO NOT have your best interests at heart.

        • Andrew D. says:

          Do you have a good source for this assertion? I assume you mean the contrast agent gadolinium, which I’ve always understood to be benign.

        • Magdalena Kegel says:

          Dear Margo,
          There is little support for the claim that contrast agents are neurotoxic. There is evidence that gadolinium, a contrast agent used to visualize inflammatory lesions, accumulate in the brain, and new recommendations state it should not be used routinely. Studies suggest that, in rare cases, people may experience immune reactions to gadolinium-based contrast agents. However, I would again point out that the evidence supporting the idea that gadolinium is neurotoxic is circumstantial at best.

        • Carol V says:

          How exactly does a neurologist ordering regular MRIs equate to “Big Pharma companies playing with your life”? Ridiculous.

        • Alan says:

          Margo Scott – you are so right!
          The pharma, insurance & unfortunately even the neurologist (to some degree) do not have your best interests at heart. There is too much red tape & risk on their part to do so. You MUST be your own advocate and do lots of reading to educate yourself. When you see your doctor – ask many questions about what you’ve read and go from there. YOU HAVE TO STAY INFORMED YOURSELF – PERIOD.

      • Adam B says:

        Personally, I’d shop for a new neurologist. I’ve been on Tysabri for the past 9 years. My neurologist schedules MRIs every 6mos to look for indications of PML. I will be migrating to Ocrevus soon. I’ve been stable on Tysabri, no new or worsening symptoms. Walking without help, work full time, etc. The Ocrevus change is to get off a 2nd line therapy with PML risk. Everything I’ve read so far indicates Ocrevus is as good as Tysabri. Insurance covers both, but they are likely happy with the lower cost of Ocrevus. No comment about Rituxan vs Ocrevus. If studied, it is likely to shake out to be similar to the efficacy between Interferons for different people.

        • Dee says:

          Adam B— I am in similar situation. Been on Tysabri for 7years, stretched to every 6 weeks for last year. JCV titer just jumped and PML risk is no 1 in 333. I dont want to leave Tysabri and neurologist n studies show said Ocrevus greatly lowers PML risk but raises other risks. Biggest concern is small relapse of prior dominant symptom, which for me was fatigue. Maybe plasmapheresis as a “hail mary pass” to stay w/Tysabri, though that has some real risks. Your thoughts, similar concerns, ideas, welcome but not expected.

      • At the age of 56, my husband was diagnosed with diffuse large B-cell Non-Hodgkin’s in his left maxillary sinus in the spring of 2009. He was treated with 3 rounds of R-Chop chemo and 20 days of radiation to 7 sites around his left eye. While he was getting the radiation, it was noted that he had developed a slight foot drop in his right foot. Upon completion of his treatments, he was deemed to be in remission, however his weakness and foot drop were so severe that he couldn’t return to work. Within a couple of months he also developed severe bladder and bowel problems and ended up with a catheter for a couple of months. At first, it was thought that his problems were due to the cancer and its treatments. As things worsened, an MRI was done which did show some lesions but when repeated numerous times the reports showed no changes and he was deemed “stable” even as his symptoms worsened. Over the last 9 years the weakness spread up his right leg and to his right hand and arm along with increasing weakness and fatigue. The last MRI showed 3 new lesions and we’ve been told they believe he has PPMS and are suggesting Ocrevus to treat it.

        Has anyone else gone from lymphoma to MS and do you think Ocrevus is advisable in his case? Any comments would be appreciated.

    • Randal graham says:

      25 years into this journey but havent had an episode in 11 years. Even though i too am in a gradual decline to the point of being in a wheelchair now, i have continued to get yearly MRI’s. You need them as a basis to judge your status or a meds feasability in the future. Docs that just treat symptoms are uninformed, lazy or both.

    • Pamela B says:

      Go to a new neurologist ASAP. Your old one is incompetent. You should have been followed by MRI’s and exploring new treatments this whole time. The great news is – there is hope for you to improve!!!

  5. undisclosEd says:

    I am 68, have PPMS, have been following this contraversial story since it first began, and there is no way that I would gamble with trying Ocrevus. This article further substantiates what those of us with PPMS have been reading for over a year now. For those out there with RRMS I do hope that Ocrevus proves to be beneficial for you.

    • Carol V says:

      What is it in this story that makes you so worried about trying Ocrevus? You’re 68, with a progressive, crippling, debilitating disease. What about the Ocrevus is worse than that???

  6. Miko says:

    Are the indicated doses for both meds the same OR lower fro MS as for RA? To this point, what might be the likelihood for PML with JVC+ patients? Furthermore, why not follow such titer levels and consider plasmaphoresis EARLY with rising levels?

  7. Ihab Tanyous says:

    I already took rutoximab for 3 doses 6 months apart now am confused to continue for rutox or switch to octu.but may case not stable bit I fear from.complications of second drug

  8. C B says:

    I had my first 1/2 dose(300mg) of Ocrevus and I am looking forward to my second 1/2 dose (300 mg) two weeks later at end of July, 2017.

    Had no reaction so far. Everyone has different tolerances to medications. I am lucky in that I am not overly sensitive to medications.

    On the day of my Ocrevus infusion, my Neurologist started with an infusion of Solumedrol, and then Benadryl at a slow rate, in order to discourage any possible reaction.
    This was followed by 300mg of the Ocrevus. It was a very long day. Over 6 hours in total that day. Keeping hydrated was important also.

    This first visit/infusion will be followed by the second 1/2 dosage of Ocrevus later this month.

    Afterwards I expect to receive a full dosage of Ocrevus infusion every 6 moths, assuming all goes well.

    After having MS for over 15 years, and having been on several DMTs, I am hopeful for this new medication.

    I hope it pans out!

    • Mike H says:

      I’ve been on Rituxan for 2 years now. Prior to Rituxan, Ive always had one good leg & one not so good leg. Now I notice that my good leg is starting to get worse. I’ve been through so many other forms of therapy prior to this. I’m ready to give Ocrevus a go at this time. I’m not afraid to try anything new. My tolerance to all meds has been good…..

      • Margo Scott says:

        Just curious if you’ve tried any dietary management of your MS? It’s great that you’re open to trying new things as I firmly believe the disease can be managed with minimal and short term medication. There are various diets to try – as you have found from your drug trials, we are all individuals who react differently to different methods.

        • Bdubs 62 says:

          Im 57 with an initial episode 30 years ago (optic neuritis). I began secondary progressive stage 19 years ago. Have tried almost every med. both on and off label with mediocre at best results. I am restricted to a scooter for nearly 10 years. and if I have learned 1 very worthwhile thing in 30 years regarding MS, it is diet is under appreciated by both Doctors and patients as a way to”manage” this disease. I have had best results with Ketogenic eating, though I am not able to “stick to it” for long periods of time only because of a lack of discipline or desire to have a “cheat” period. My overriding rules are to try and minimize sugar, gluten and carbs and dairy. That should help. Fasting is also terrific!

  9. Robert C. says:

    My sister (early 50’s) has RRMS and recently had a significant flare-up. Before that, she had managed without medication and strict compliance with a diet thought to be helpful. She is about to have her first infusion of Rituxan this week followed by another two weeks later.

    I know that side effects and site reactions can differ for each patient. But I’d like to understand what any of you have experienced, positive or negative, to better educate myself – if you’re willing to share. Thank you to any of you that may do so and I wish you g-dspeed in your journeys.

    • Pamela B says:

      I had allergic reactions to Ritux with both of my infusions. But with double dosing Sulumedrol and Benadryl and slowing the rate I was able to tolerate the infusions. Not sure yet if they are working. Be prepared for a long day either way, bring reading material – (4-9 hours)

    • Bonnie Lim says:

      Hi Robert,

      I have been on Rituxan for a year now and I have to say I am very pleased so far. I have been on so many meds and because I have JCV+ with a very high antibody count I’m limited on what meds I can take. I’m also highly allergic to Cooaxone and Tecfidera, which gives me head to toe hives and swollen lips:-( so Rituxan has been a God’s miracle for me:-) I went from having major flares with solumedrol treatments every 3 months to having, so far, zero flares for a solid year! Also my MRIs went from numerous active lesions from my brain down my spinal to zero active new lesions😁 I pray every day that this continues for years to come. Since I’m a mother of 3, 1 being a toddler, I enjoy my naps every 6 months lol the Benadryl knocks me out lol I wish your sister luck and I will pray that she gets the great results that I have received. We all deserve a great quality of life! ❤️

    • Kristen rutter says:

      I’ve been on the Rituximab for 4 years now and have had no reactions what so ever. I don’t need a cane except as support if I’m going to spend an entire day walking. I switched my diet to Mediterranean and my fatigue is less. I also take natural supplements like essiac which help my overall well being. No new lessons have shown up in almost 3 years now.having a great neuro is so important. I love mine
      He stays on top of everything and researches anything new coming out.i agree that you need to be your own advocate.

  10. Steve Wine says:

    I have have been diagnosed with MS over 25 years ago. I was on Tysabri before I switched to Ocrevus.
    Check with the protocols about the time needed to be off old treatment before starting Ocrevus. I felt significally better after the first 1/2 dose of Ocrevus. I had no side effect with respect to itching during the infusion.
    My gait is much faster when walking, I can walk greater distances, my left leg ( used to swing it) functions better and my cognitive is vastly improved.
    I would encourage people to talk to your MS professional about giving Ocrevus a try.
    P.S. I get MRI, w/o contrast, every 6 months.

    • Dee says:

      Steve W: I also w/MS for approx 25 years, MRI w/contrast every 6 months and things pretty good w/tysabri. BUT my JCV titer now makes neurologist strongly suggest a switch to Ocrevus. As some cognitive issues(recall of names, some exec function stuff) is one BIG thing i’d love to improve and you have no problems w/Ocrevus, sounds like i should seriously consider switching like you did. Good luck

  11. james vincent jackson says:

    I was diagnosed in 2014 with MS but had symptoms probably a year or two before that. Anyways the only medication I ever took for it was tysabri Jan 2014 which was for one infusion which I did not tolerate due to an allergic reaction (life threatening reaction). Then in the meantime took gillenya for over 6 months which showed no positive results. My doctor decided to do a plasmapheresis to clean my plasma and put me on rituxin. I’ve been on rituxin since then and my life has been changed completely. I’ve been switched on dosing and take it once every 4 months and I exercise (strength/ resistance training) regularly and run/sprint whereas I was unable to (literally used a cane to walk amongst many symptoms). I am a 27 year old male and possess a bachelors degree in exercise science and currently doing my masters in nutrition. Therefore I can say exercise and nutrition are definitely key factors in controlling MS disease activity along with proper medication.

    • Lorilyn Cochrane says:

      Hi. I have had RRMS since Oct 2000, I am now 45 years old. I’m also a RN. Your reply to this long chain of comments is 1 that I related to the most. Exercising routinely for almost 9 years now has helped tremendously. Prior to that I used a cane, 2 forearm crutches, walker, electric wheelchair, & normal wheelchair.
      I’ve been on multiple treatments for MS. The ABC injections, Rebiff, 1 dose Rituxin (caused temporary CHF), multiple Solumedrol IV through out the years, Tysabri for 8 yrs (JC viral positive now), Lemtrada in 2017 (day 5 had a MI), Lemtrada 2 doses last year (the 3rd dose couldn’t be started bradycardia in the 30’s).
      Now Neuro wants me to take Ocrevus. Is it still helping you? Despite all of the treatments lesions continue to grow. I have 3 new lesions in the past year. My MRI’s look like swiss cheese. Presentation wise I’m stubborn walking with a cane still exercising. Unable to work. Sorry to bore you.
      I’m intrigued by your exercise routine and diet. Supplements? I take B12 injections weekly and Vit. D daily. I’m heat intolerant but born and raised in Florida. Are these medications doing more harm than good? I wonder sometimes if I should just stay with my symptom medications (which are now at 5 instead of the 20 plus due to weaning off most by myself). I’m not asking for any medical advice just your personal experience. Plus it would be nice to converse with someone that could relate on an intellect level that also is involved with healthcare and has MS.
      Looking forward to hearing from you…

  12. Raymond says:

    I no longer take any meds
    because, frankly, I lost all trust in Neurologists and Pharma
    I now have been set on Sativex and never look back to the old Rebif days

    • Carol V says:

      Raymond, Sativex treats symptoms only. You are risking disease progression and permanent loss of function by failing to treat the disease process itself. Isn’t it a bit reactionary and foolhardy to lump all neurologists and pharmaceutical companies together and discount them in such a way? This attitude won’t hurt them one bit, but it certainly may hurt you.

  13. Stephen Hunt says:

    To put it in perspective, my wife’s insurance is charged $117,000 per dose for Ocrelizumab (that’s $234,000 per year), vs just $8,300 for Rituximab infusion. The insurance pays $75,000 per infusion, or $150,000 per year to Genentech. I can upload images of the patient bills if you would like to see them. I am a physician (MD/PhD from Stanford University now faculty at Penn), and I find this unconscionable. Know that pretty much everyone touting this drug is on the payroll of Genentech, as speaker or consultant. This can easily be looked up on publicly accessible databases.

  14. Eric Hills says:

    So I want to know. My neurologist said that my Rituximab regiment would be one infusion every six months for 3 1/2 years then one every other year for two years then another one 4 years after that then I’m done. Supposedly after that your being sales come back different and they don’t attack the Mylan anymore. So I can’t find any information on that just what he says.

  15. Rod Kalisek says:

    So many discrepancies in evaluations of All MS drugs. The Biggest is that nobody seems to tell the truth and the pharmecutical companies only want to pad their pockets. Poor MS patients.

  16. David says:

    I find myself reading this article instead of working because I am having break-through symptoms while on Ocrevus. I have now had 3 infusions – Jan 2018, July 2018 and Jan 2019. Overall I am satisfied, but when I was on the predecessor Rituxan I managed to have little to no break-through symptoms. I had achieved ‘the zone’ you want to be in. I’d be curious to see if we’re going to learn that Rituxan was actually more efficacious than Ocrevus. I also would like to know why the infusion schedule was changed to one time (all of it in one sitting) and not given over a two week period. Are we getting all of the targeted cells? Or leaving more than desired behind? Layperson question, I know – but it’s a variable as I compare the two drugs.

  17. Fiona says:

    My neurologist told me that the company that makes Tysabri owns the patent on the testing for the JC Virus- the precurser virus for PML. Anyone know anything about this?

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