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

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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