Here is My Question:
Does Kesimpta give you hair loss?

Answer:
We have not observed any hair loss with Kemsimpta. Some people report mild transient hair thinning with Ocrevus but this is because it is co-administered with steroids to prevent infusion reactions. Steroids are well known to cause hair thinning

Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego

Here is My Question:
Which drug is better, Ocrevus or Kesimpta? I don't know which one to choose...

Answer:
Ocrelizumab (Brand name Ocrevus) and Ofatumumab (Brand name Kemsimpta) are the two currently approved anti-CD20 monoclonal antibodies for the treatment of multiple sclerosis. Both treatments are FDA approved for relapsing forms of multiple sclerosis. They are both humanized monoclonal antibodies (IgG1 subtype) that bind to a protein called CD20- a marker for all B cells beginning at the pre-B cell stage - and destroy these cells. Once destroyed these cells are gradually replenished over time by stem cells in the bone marrow. The extent and duration of B cell depletion depends on the method of administration, the dose administered, the interval between administered doses and several host factors (e.g. age, weight, prior immunosuppression).

Both drugs are highly effective in relapsing forms of MS; although it is difficult to directly compare efficacy or safety without head-to-head clinical trials the reductions in annualized relapse rates, sustained disability progression and MRI measures of disease activity were similar for both drugs compared to the comparator drugs for each study, Rebif for the Ocrevus phase III clinical trials and Aubagio for the Kemsimpta Phase III clinical trials. 

So how do you decide between these different treatments? I've attached a table summarizing the pros and cons of each treatment, at least relative to the other treatment. To understand this table it is important to first understand several important concepts

1. It is NOT necessary to deplete (destroy) totally or continually circulating B cells to control Multiple Sclerosis. For instance, we know that a single course of intravenous rituximab, another anti-CD20 monoclonal antibody, will suppress relapses and MRI activity for over a year and well after naive B cells repopulate. We also know from the phase II Kemsimpta trial that robust treatment effects were observed with doses as low as 3 mg every 12 weeks (note that the approved dose is 20 mg every 4 weeks) despite only partial depletion of total B cells.
2. B cells are very important cells in your immune system . They mount responses against foreign invaders like virus and help regulate other essential immune functions. Persistent depletion of B cells can and often does have negative consequences especially after several years. Persistent depletion of B cells, especially naive B cells,also makes it more difficult to develop a good immune response to vaccines; this would include the COVID19 vaccine

In summary both Ocrevus and Kemsimpta are outstanding treatments for MS. The main differences are the mode of administration (intravenous for ocrevus and subcutaneous for Kemsimpta) and the duration of B cell depletion after a single treatment (much longer for Ocrevus). Of course, Ocrevus has an obvious advantage for primary progressive patients, since it is the only medication approved for this indication as well as relapsing forms of MS.

You can open the file below to see the pros and cons of each drug.

Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego

Here is My Question:
Can you have gastric sleeve surgery if you have multiple sclerosis

Answer:
Gastric sleeve surgery is not contraindicated in MS.  

​A. Scott Nielsen MD MMSc
Neurologist and MS Specialist at Kaiser Permanente

Here is My Question:
Is ‘stable’ a good MRI result 18 months post-aletizumab? Is it the same as NEDA?

Answer:
We prefer explicit descriptions in our MRI reports. Words like "large", "numerous", or "small" are vague and of no meaning. "Stable" on the other hand means there are no changes, for better or worse, compared to a prior study. "Stable" would be equivalent to 'No Evidence of Disease Activity' (NEDA3), if there are no new or enlarging T2 hyperintensities and no enhancing lesions.

Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego