MS News that Caught My Eye Last Week: Rituximab vs. Ocrevus

Ed Tobias avatar

by Ed Tobias |

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Ponesimod, telemedicine

In this week’s column, I’ve changed the format a little to focus on one subject: rituximab. This is an approved cancer medication that some U.S. neurologists use as an off-label treatment for multiple sclerosis (MS). Rituximab is similar to Ocrevus (ocrelizumab). When the latter disease-modifying therapy (DMT) became available in the U.S., some people with MS who were being treated with rituximab switched to the newly approved DMT.

But I know one woman who switched back to rituximab after about two years on Ocrevus. She seems to have fewer side effects with it. Each of the following stories is from a three-part report based on the rituximab versus Ocrevus discussions that took place at the ECTRIMS conference last month.

#ECTRIMS2019 – Is Rituximab a Reasonable Option for MS Patients?

More than two years after the approval of Ocrevus (ocrelizumab), B-cell therapies continue to be seen as promising approaches for multiple sclerosis (MS). But it has been debated if rituximab — a B-cell therapy used off-label in MS and also marketed by Genentech — could provide similar or even superior benefits compared with Ocrevus, and at a lower cost.

This question was the focus of a hot topic discussion at the 35th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), held Sept. 11–13 in Stockholm, where a group of researchers and neurologists voiced their opinions about whether or not rituximab is a reasonable alternative to Ocrevus for people with relapsing MS.

Click here to read the full story.

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#ECTRIMS2019 – Is Rituximab a Reasonable Option for MS Patients? Yes, Researcher Says

Fredrik Piehl, MD, PhD, says yes, explaining in his presentation at ECTRIMS why he believes rituximab is a reasonable therapeutic option for MS.

Piehl is a neurologist and professor at Karolinska University Hospital and Karolinska Institute in Sweden.

He is also the principal investigator of a large, long-term observational study called COMBAT-MS (NCT03193866), the purpose of which is to investigate whether rituximab offers advantages over other commonly used disease-modifying treatments (DMTs) in relapsing-remitting MS (RRMS) patients. Both untreated patients and patients switching from a previous first-line DMT are being enrolled.

Click here to read the full story.

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#ECTRIMS2019 – Is Rituximab a Reasonable Option for MS Patients? No, Researcher Says

Mitchell Wallin, MD, MPH, a neurologist and professor at George Washington University and the University of Maryland, says no, explaining in his presentation at ECTRIMS why he believes rituximab is not a reasonable alternative for the treatment of MS.

Wallin, who is also the director of the Veterans Affairs MS Centers of Excellence-East, wrote an article last year titled “Rituximab is an acceptable alternative to ocrelizumab for treating multiple sclerosis – No.”

Click here to read the full story.

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Comments

WILLIAM MORRIS avatar

WILLIAM MORRIS

TELL ME SOME TRUTHS ON TREATING AND CURING PRIMARY PROGRESSIVE MULTIPLE SCLEROSIS!

OCREVOUS IS NOT THE ANSWER AS ITS MAIN SIDE EFFECT IS DEATH!

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Helen avatar

Helen

Hello William, I am looking to change from this but don’t know what the alternative is. Please help

Thanks Helen

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Mer avatar

Mer

Mr. Morris, there is no cure for MS

Reply
Mark avatar

Mark

...but I'm going to give it a damn good try!

Reply
cheryl freeman avatar

cheryl freeman

ocrevous has been recommended for me. i have late stage ms and seropositive ra with rheumatoid lungs and heart and liver issues. methoxtrate only made me worse; i am afraid to start the ocrevous since mtx was so hard on me. i do not know what to do. i have lesions in white and gray matter.

Reply
Ed Tobias avatar

Ed Tobias

Hi Cheryl,

It's difficult to judge how you might respond to Ocrevus, just as it is for any DMT. Some Ocrevus users might share their own experiences with you here. If that doesn't happen, there are some Ocrevus user groups on Facebook where you can asks your questions.

Good luck,

Ed

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