An Ocrevus Update Has Me Cautiously Optimistic

An Ocrevus Update Has Me Cautiously Optimistic

Engaging Thoughts

After a delay in treatment in late December thanks to a nasty head cold, and the after-effects of contracting the flu in February necessitating another delay, I finally received my second six-month dose of Ocrevus (ocrelizumab) in mid-March. Much like the first time, the infusion was uneventful. I had no problems with flushing, itching, elevated temperature, or any of the other potential side effects during the infusion. I know other people have a wide range of problems, so I feel fortunate that I am among those who experience nothing unusual.

Infusion time

Once again, the worst problem I had was being stuck in the infusion suite for six hours while thinking of all the other places I wish I could be. The first round of Ocrevus requires two separate infusions, separated by two weeks’ time. These initial induction rounds are only four hours instead of the six hours needed for the full dose I’ll receive in the next round of Ocrevus. Boredom was my No. 1 complaint then as well.

Everyone wants to know: Do I feel different, or have I noticed any benefits? Honestly, again, I have to say I know I am no worse, and it takes time to turn around the course of multiple sclerosis. I don’t expect it to magically happen overnight, but there are signs that perhaps something different is going on.

Changes

I saw my neurologist the following week, and we were able to review my tests and the results from my annual MRI, done in late 2017. Thanks to an analysis by NeuroQuant software, I knew some things changed. The doctor also pointed out that the report showed a couple of changes for the good, which may or may not be from Ocrevus. The atrophy of my brain, due to both MS and aging, may be slowing or even improved. The NeuroQuant analysis compared my MRIs, which were done one year apart, and found these changes:

NeuroQuant Whole Brain: Normative percentile 33. This was previously 26.

NeuroQuant Thalamus: Normative percentile 70. This was previously 48.

The increase in the thalamus is especially of interest to the doctor and me because this is an important piece of the brain that helps process signals to the rest of the brain. These signals include critical functions such as sleep and consciousness. My neurologist views this increased thalamus size with cautious optimism, knowing it is too soon to be sure of its implications. We will continue to watch for improvement via my next MRI.

Other improvements

Interestingly, I also performed better on the nine-hole peg test and the symbol digit modalities test compared to last year’s results. These are standard tests given at each of my neurology visits. In “real life,” I will never need to put pegs in holes, but the ability of my brain to control my hands to do a small motor skill like this is something I use all the time. I also will never need to match symbols and numbers under the pressure of a timed test, but it is a good indicator of cognitive processing speed. I’m cautiously happy with both of these improvements.

It’s encouraging to think there may be improvements in my MS rather than a continuation of the downhill slide I have experienced over the years. I may not be walking faster, but Ocrevus may be quietly working on other functions like thinking and the ability to use my hands, which I value even more. While these improvements remain anecdotal, I hope to find continued improvement the next time I engage with my neurologist.

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33 comments

  1. Phil Longford says:

    Hi Laura
    Is your MS relapsing remitting, or primary progressive?
    Sounds encouraging though. Seeing my consultant next month. Hopefully he will agree to the treatment!
    All the best
    Phil

    • Karen Bookless says:

      Good luck Rita, I am due my second dose in July and, touch wood, have had no problems so far. I am being positive and am hopeful this will halt my progression, onward & upward…

  2. Lydia says:

    I am curious, are you diagnosed as RRMS, SPMS, or PPMS? Also, pardon my asking… your age. I am contemplating my next move, but at 54 and non active MRI’s wonder if it will benefit me. Risk versus benefit issue.

  3. Ken says:

    I’m really happy to read how you’re doing and the small gains you’ve been seeing. I start Ocrevus in a few weeks and have my share of anxiety. There are so many negative people on line complaining about the whole process. They’re miserable during and after the first infusions and swear the Ocrevus did nothing for them. I am a lot more positive about how I’m going to do and your story has made it a little easier to do so

    • Ann says:

      My husband 54, has benefited from Ocreves, plus he was walking bad and for the 3rd time tried Ampyra, the walking drug… 3 is a charm
      He has RRMS

      • Ann says:

        I’ve been with my husband as the constant Advocate. He’s been fighting this horrible disease since 2007… we think he started it in 2001, with vision problems.
        He had been a 6’2″ good looking contractor when I meet him. Strong as 2 men, avid reader, muy intelligente. Praying & waiting for a cure.Meanwhile positive attitude imperitive…
        I helped immediate family thru 2 COPD, 2 Cancer, my diabetic type II now. Hang in there!
        Ocrvevus is his 5th medicine, it and Ampyra, have helped greatly… naps, R&R

    • Good luck Ken. If people are having a decline due to Ocrevus, we have every right Perhaps further down the track I may see some positives but so far I have lost my job due to the cognitive decline after 16 years on Tysabri. Apparently, my disease is progressing now due to the lymphocytes being able to cross into the brain where previously they couldn’t.

  4. Alicia says:

    Thank you for your article. I too am on Ocrevus for PPMS, however, I have not met the one year mark yet. The one year Ocrevus anniversary will arrive this June. I too am cautiously optimistic. I have not declined in symptoms for the first time in several years. My gait has not gotten “faster”, but it has not declined either. Yes, the infusions are long and boring, but I am grateful the whole infusion time that there is a treatment for PPMS. I would sit in that infusion chair for a week if I had to!

    • Stephanie Bowen says:

      If you have been on Lemtrada, can you have Ocrevus? I am a little better from 2 rounds of Lemtrada for gait and balance, but nothing in shaking and coordination or cognition.

  5. Joshua Kalnitsky says:

    I will be seeing my MS doctor early May. I hope to try any thing to get some relive from this horrible felling.

  6. Al says:

    I have PPMS and had 2 rounds of Ocrevus infusions. Both times I have had more progression right after the drug. Walking, balance, tremors, spasticity, infections, etc. became worse for months until the drug started wearing off and B cells were growing again. The benefit of possibly slowing PPMS progression up to a max of 24% is not worth the risks associated with the drug. It may help some, but until a treatment that restores myelin is available (and there are several studies in the works now) we won’t heal or potentially repair our nerves. Hope is great to have, but before believing this is a cure or reversal will start, do some research. It’s not easy to do being bombarded with ads and stories of the “game changing” drug, but is well worth the time. If it helps you, wonderful, but for those that are questioning benefit versus risk, it’s worth asking.

  7. Carolyn Kelley says:

    Very helpful to read different peoples experience. I’ve been diagnosed since 2014 and have seen a marked decline in the last 6 months on Copaxone. We decided to make the change to Ocrevus, but I am waiting to find a facility that is in network for my insurance . A bit frustrating to say the least. I concur with Al to some degree and am hoping for myelin restoration breakthroughs as the next treatment. There’s got to be something more permanent and, preferably, natural. Until then, each day is a new reason to remain faithful.

    • I am 66 and have had MS since 1986. I started Ocrevus this year. After reading all the comments, Yes,, maybe there is an improvement. I am also going to a physical therapist and I do seem to be walking better. Not much improvement with my balance however. If that would improve I could give up my walker and just use a cane.
      I am experiencing one side effect that wasn’t mentioned and that is dry mouth. Has anyone else noticed this worse than before?

  8. John says:

    Have a friend that is on Copaxone and had one episode of optical neuritis. He was told to forget about Copaxone and start on Ocrevus immediately. He is only 30 years old and I would rather he stay on Copaxone. What should I tell him?

    • Teresa Lawson says:

      Hello John, This is my first time to see/ read/comment at this site. I was compelled to mention my excellent experience with Tysabri. If your friend tests negative for the JC Virus he might consider Tysabri. I was infused once a month with Tysabri for 10 years. Being on that drug for a decade is rather unusual but I am SO very grateful for those 10 years. I feel that I improved ( better balance, walking, clearer thinking) and stayed VERY stable while using that treatment. Prior to Tysabri I was using the injectable Beta Seron for 7 years and began to decline. My neuro and I agreed to switch meds and I am so glad I did. I would recommend you and your friend do some reading about Tysabri before going to “the big guns” with Ocrevus. (Unless his doctors feel he is possibly PPMS, Primary Progressive MS). Ocrevus is being prescribed for folks who seem to be declining rapidly or for folks who have failed other MS treatments. I wish your friend well and he is fortunate to have you on this team!

  9. Lexi Wilson says:

    Interesting reading the comments of people who have tried Ocrevis. I have SPMS and am thinking of trying Ocrevis though have questions about side effects of the drug. I’ve heard different things about the drug that sounds scary plus I have to wait for Kaiser to approve it’s use. Thanks for your comments about Ocrevus. Spell check didn’t change it this time. Bye now

    • Susan says:

      Hi Lexi. I have Kaiser too. I looked into their formulary of drugs and I saw Ocrevus in there. I’m still on Copaxone but still considering a change to Ocrevus. I wonder why someone at Kaiser says they don’t use it.

  10. StarGzr says:

    That news is certainly encouraging! Thanks for sharing. Your post is the first that I have come across that mentions NeuroQuant analysis. I had this analysis performed on my MRI last year, and received very disturbing results regarding my hippocampal and ventricular volumes. I am curious if these particular measurements were performed as part of your analysis?

  11. ROnith says:

    I just recently switch from Gilenya where I had no new lesions for 7 years while on drug
    Felt fantastic
    I have a very busy life as a single mom of two girls and not much
    My white blood cells drop so my neuro decided I needed to switch to ocevis
    I have had completed my first round and have not been doing well. Not sure what is happening but I am having terrible drop foot/walking problems and just all around not feeling good …
    I had an MRI and blood work taken last week so hopeful to get some answers

    • K says:

      Hi, first time on site, I too am on Ocrevus, and finished the first 2 half doses. I am not feeling well either. My fatigue is awful at this time. I will be seeing my doctor next week and ask for blood tests to be run. Very concerned

  12. Merblair says:

    The thing that everyone seems to forget is that this disease is like a chameleon, which is the reason we don’t have a cure yet. I am a very happy with any dmts that have been offered. I would do stem cells if I was younger. It might give me a few years without MS.

  13. Shirley says:

    Hi my friend Laura!
    I was not impressed with Lemtrada and feel it has made me feel ten years older than I am. I’m about two years post infusion.
    I think I will discuss this with Doc next month. The first dose separated by two weeks will be my only hard part. I am 8 hrs from my neuro.
    I am 76 and just got out of neuro icu for subdural bleeds from 2 falls.

    • Steve Stine says:

      I was diagnosed with PPMS in December 2017 started the first Ocrevus right away also on amprya have many symptoms to numerous to list my walking has gotten better but every time I walk more than forty yards about as far as I can walk at one time it takes days to recover now it is getting warmer I feel like I am starting to go backwards or else the effects of the meds are wearing off

  14. Haslie Kemp says:

    I am not waiting for a cure. I have today and I am going to live life to the fullest one day at a time. Each day is a challenge and I meet it head on. You see, I have nothing to lose. I was diagnosed in 2010 with SPMS with no treatment after being in a wheel chair for 5 years and symptoms for over 30 and I am not 78yrs old so I also have other medical problems but life goes on.

  15. Angie Anderson says:

    I tried Copaxone and had a horrible experience. Now they want me on Lemtrada. But I really want Ocrevus but they told me it causes cancer. I am not sure on that can someone tell me about that.

  16. Kathy says:

    Thank you Laura . I had my first treatment last month mid May. I follow it with my neurologist June 26. I have RRMS And previous to Ocrevus have only taken Copaxone since 2004. I had no side effects to the actual infusion but since receiving the treatment my walking is worse with severe back pain and I am going to have to use a walker .

  17. Kimberly says:

    Hi, first time on site, I too am on Ocrevus, and finished the first 2 half doses. I am not feeling well either. My fatigue is awful at this time. I will be seeing my doctor next week and ask for blood tests to be run. Very concerned

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