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Here is My Question:
I am being switched from Rituximab to Truxima for my next (3rd) infusion. I am worried about a change and if Truxima has been tested at all on MS? Answer: Truxima is a biosimilar rituximab that was reviewed by the FDA. It's labeling is Truxima (rituximab monoclonal antibodies). Rituximab was tested in phase 2 clinical trials for MS and was found to be effective. There is no material difference between Truxima and Rituxan (the original brand name of rituximab). A. Scott Nielsen MD MMSc Neurologist and MS Specialist at Kaiser Permanente
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Here is My Question:
I am afraid to have my injection treatment done. I am struggling physically and emotionally, and don't feel like my body can take a 6 hour procedure (prolonged sitting is difficult for me). I am also very concerned about side effects and my ability to return to work right after the treatment. I am already dealing with weakness and fatigue that is limiting my current work schedule. Should I prolong getting the treatment done until a time where I feel better? Answer: It is impossible to answer your question without further details and knowing your case. Here is what I can say:
I assume in your message you are talking about an Ocrevus infusion. Ask yourself and your health team the following questions: -Why do I need the treatment now? Can I change the infusion date to a more convenient time? -WHy do I need 6 hours of infusion time? Can I take half the dose (300 mg) with a shorter infusion? -What can you do differently with this infusion to limit the side effects experienced during the last infusion? -Are there alternative treatments we have not discussed and what are their risks and side effects? I find if you ask the right questions and find someone who can provide the answers, it allays many of your fears and anxieties. Good luck to you. (Rip) Kinkel MD Professor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego Here is My Question:
Will having MS interfere with my chances of getting a job in the medical field? Answer: The diagnosis itself shouldn’t be a factor. However any disability as a result of MS could potentially limit you if the essential job functions are impacted by the disability. As a general rule, I recommend not disclosing the diagnosis to an employer. A. Scott Nielsen MD MMSc Neurologist and MS Specialist at Kaiser Permanente Question:
I have swollen lymph nodes on either side of my groin. Is this from Copaxone? My blood tests came back clear and I had a scan that they said there was nothing they could see that was dangerous but that the swelling was definitely reactive. I’m thinking about coming off copaxone! Answer: One of the less common side of effects of Copaxone is swollen lymph notes near sites of injections, usually in the groin or inguinal region. There is no reason to stop the Copaxone unless the swollen lymph nodes are painful or the Copaxone is not benefiting your MS (Rip) Kinkel MD Professor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego PLEASE NOTE: The information/opinions on this site should be used as an information resource only. This information does not create any patient-HCP relationship, and should not be used as a substitute for professional diagnosis and treatment. Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition. Here is My Question:
I am currently on Rituxan and was wondering if wearing a face mask is recommended when visiting a hospital (family member having surgery, not sick). What circumstances would you recommended patients wear a face mask, if at all? Answer: I understand we are immunocompromised, but not in the typical way that we know it to mean (being on Rituxan). Would you be able to elaborate on this?People on rituximab, Ocrelizumab and other anti-CD20 agents do have a slightly increased risk of upper respiratory tract infections (URT) and perhaps pneumonia. The risk of URT infections is higher if you are older (over 50) and/or more disabled (limited mobility or wheelchair bound). It seems prudent to wear masks and/or avoid people with URT infections (e.g. hospital visits)during high activity flu seasons, such as this year, if you meet these criteria. (Rip) Kinkel MD Professor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego Here is My Question:
My wife has lesions on her brain and spine but they are inactive. Does this mean she doesn't have MS anymore? That is an excellent question. Answer: We define "activity" on an MRI by the development of new or enlarging white spots (also called T2 hyperintensities) over an interval of a year or less or by the presence of typical gadolinium enhancing lesions on an MRI at any time. Scans with any of these features are said to be "active." Active MRI scans are far more common in younger relapsing remitting people with MS (under age 45) and especially in those not on disease modifying therapies. Once individuals are over the age of 45, it becomes less and less common with further aging for MRI scans to show short term activity (observed over an interval of a year or less) The absence of activity on an MRI scan does NOT mean the person no longer has MS or the disease is in remission. There are many reasons for lack of activity on an MRI including but not limited to the following reasons:
(Rip) Kinkel MD Professor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego Here is My Question:
Is small fiber neuropathy the first sign of MS? Answer: Small fiber neuropathy is a peripheral (not central) nervous system injury. This is not a manifestation of MS, but would reflect a different (or additional) condition. A. Scott Nielsen MD MMSc Neurologist and MS Specialist at Kaiser Permanente |
PLEASE NOTE: This information/opinions on this site should be used as an information source only. This information does not create any patient-HCP relationship, and should not be used as a substitute for professional diagnosis and treatment. Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition.
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