Why Ocrevus is a new favorite drug by doctors?

Discuss Ocrelizumab, a monoclonal antibody treatment for MS.
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Optimistic99
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Why Ocrevus is a new favorite drug by doctors?

Post by Optimistic99 » Thu May 16, 2019 12:31 pm

I am a new member of this family, and wanted to explore about this medicine.
I have been recently diagnosed with MS and 2 doctors in two different countries have prescribed this medicine. I am a little confused whether it's a safe drug or not as the internet reveals a lot on the serious side effects of Ocrevus.

Anunymouse
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Re: Why Ocrevus is a new favorite drug by doctors?

Post by Anunymouse » Sun Jun 16, 2019 7:19 pm

The main side effects are during and post infusion. I'm one of the lucky ones that gets a rash. I also feel run down for about a week afterwards but there's a reasonable chance it's psychosomatic. I get the infusion done at the local cancer center and I find the whole thing even more depressing than normal. I believe 2 women in one of the studies was dxd with breast cancer by the %s weren't outside the population norm. It's still worrisome to me, but so is being bedridden.

It's relatively inexpensive compared to many ms meds. It has fewer side effects than many. It has a higher efficacy than most and it's only done twice a year. So there are a lot of positives to it.

It's a fairly aggressive drug compared to the crab drugs, which are mainly side effects and essentially 0 benefit. Personally I believe you should attack disease as hard and as fast as possible, not take years of Taking things proven to not work until things have gotten so bad the aggressive drugs won't work either.

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NHE
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Re: Why Ocrevus is a new favorite drug by doctors?

Post by NHE » Sun Jun 16, 2019 8:15 pm

Anunymouse wrote:
Sun Jun 16, 2019 7:19 pm
The main side effects are during and post infusion. I'm one of the lucky ones that gets a rash. I also feel run down for about a week afterwards but there's a reasonable chance it's psychosomatic. I get the infusion done at the local cancer center and I find the whole thing even more depressing than normal. I believe 2 women in one of the studies was dxd with breast cancer by the %s weren't outside the population norm. It's still worrisome to me, but so is being bedridden.

It's relatively inexpensive compared to many ms meds. It has fewer side effects than many. It has a higher efficacy than most and it's only done twice a year. So there are a lot of positives to it.

It's a fairly aggressive drug compared to the crab drugs, which are mainly side effects and essentially 0 benefit. Personally I believe you should attack disease as hard and as fast as possible, not take years of Taking things proven to not work until things have gotten so bad the aggressive drugs won't work either.
Ocrevus vs. placebo on disability progression. Two data plots which are nearly identical. I've asked this question before, maybe you can answer it. What am I missing?


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ElliotB
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Re: Why Ocrevus is a new favorite drug by doctors?

Post by ElliotB » Mon Jun 17, 2019 10:00 am

"Ocrevus vs. placebo on disability progression. Two data plots which are nearly identical. I've asked this question before, maybe you can answer it. What am I missing? "

The same is pretty much true for Copaxone and the few other MS drugs I have taken a close looks at. You are probably not missing anything, ALL the MS drugs likely have little effect, if any at all!

I have not found one that stands out! And the pharmaceutical companies seem to use 'fuzzy math' to present the results of their trials.

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NHE
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Re: Why Ocrevus is a new favorite drug by doctors?

Post by NHE » Mon Jun 17, 2019 7:39 pm

ElliotB wrote:
Mon Jun 17, 2019 10:00 am
I have not found one that stands out! And the pharmaceutical companies seem to use 'fuzzy math' to present the results of their trials.
It's not just "fuzzy math" such as using relative percentages to amplify small differences. In the above data plot, there are a considerable number of "censored" data points especially in regions of the Ocrevus plot where the slope tends to differ from the placebo plot perhaps helping to contribute to any apparent overall difference.

HarbourBoy
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Re: Why Ocrevus is a new favorite drug by doctors?

Post by HarbourBoy » Mon Jul 08, 2019 4:14 pm

I think that chart reflects a 25% reduction in progression compared to no treatment. It’s not much but I guess 25% is better than nothing. I might be wrong

Anunymouse
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Re: Why Ocrevus is a new favorite drug by doctors?

Post by Anunymouse » Tue Feb 11, 2020 1:32 pm

Placebo in MS is a big problem (to me) in most of the studies. A while back the Dr. recommended aubagio for me (after prescribing and then telling me not to take tecfidera). I was talking to one of the nurses at an appointment and she asked me what I was on. At that time, nothing. I told her I tried aubagio for a month and the side effects made life unliveable so I was off everything. She kind of lost her mind "you have to take xxx!"

Every advertisement says "compared to placebo", but not telling me the placebo results makes it a worthless statement. If 99% of people improve on nothing, an extra 8% doesn't matter. Odds are I need nothing. So I read a bit and found...

The difference between placebo and aubaigio was 8%, which is with in the range of error in most studies. She said no. I said yes, every study showed that there were only 8% more people that showed improvement compared to sugar pills. So in a room of 100 people, 8 might actually be helped by the drug. Odds are, I won't be one of the 8.

EVERY study I've found on the mainline drugs show essentially NO change in progression time compared to doing nothing. They may cut back on relapses, but if you're in a chair in 5 years with no drugs, you're in a chair in 5 years with the drugs. Ocrevus supposedly slows that time down. You're still in a chair at the end, it will just take longer to get there.

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Re: Why Ocrevus is a new favorite drug by doctors?

Post by jab54 » Thu Mar 19, 2020 9:47 am

I am concerned with evaluating the risks versus benefits of my next ocrevus infusion, esp. when there is a coronavirus pandemic.
1. If I skip my next ocrevus infusion will my MS progression rate be worse than before?
2. Is there evidence, prior cases, that reflect how primary progressive patients react to missing an ocrevus dose?

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Re: Why Ocrevus is a new favorite drug by doctors?

Post by Anunymouse » Sat May 09, 2020 8:29 pm

jab54 wrote:
Thu Mar 19, 2020 9:47 am
I am concerned with evaluating the risks versus benefits of my next ocrevus infusion, esp. when there is a coronavirus pandemic.
1. If I skip my next ocrevus infusion will my MS progression rate be worse than before?
2. Is there evidence, prior cases, that reflect how primary progressive patients react to missing an ocrevus dose?
I dont believe so. I think you run into serious ethical issues if you take someone off their meds for a study. If we assume that ms takes decades to ramp up, it should take some time to ramp up if you miss a dose.

Im kind of off meds right now. Due to my drs office dropping the ball, I was a couple months overdue on my last dose. And then a "I've never seen that before" incident ended with 2/3 of my infusion on the floor and in the trash. The neuro apparently wasnt too concerned, which puts doubt in my mind about how important to him it actually is. He's the go-to ms specialist in my part of Florida.

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NHE
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Re: Why Ocrevus is a new favorite drug by doctors?

Post by NHE » Sat May 09, 2020 9:04 pm

Anunymouse wrote:
Sat May 09, 2020 8:29 pm
Im kind of off meds right now. Due to my drs office dropping the ball, I was a couple months overdue on my last dose. And then a "I've never seen that before" incident ended with 2/3 of my infusion on the floor and in the trash. The neuro apparently wasnt too concerned...
"No problem. Just charge the patient's insurance for the full dose even though they only received 1/3 of it."

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