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Is it possible to get worsening of MS symptoms from a tooth infection (its a slight infection).9/1/2023 Here is My Question:
Is it possible to get worsening of MS symptoms from a tooth infection? (its a slight infection) I'm getting it extracted to avoid any possibility of a root canal failing or reinfection in the future. In addition, I wanted to see if antibiotics are needed before procedure? My DMT is Rituximab, so wanted to get some clarification if there were any contradictions. Thank you for your time! Answer: Infections, usually symptomatic but sometimes asymptomatic infections, are one of the most common reasons for worsening of MS symptoms. This is called a pseudo-relapse, because it is usually not possible to find evidence of acute inflammatory activity in the brain or spinal cord when this occurs. The dentist or orthodontist will determine if there is an acute infection or abscess that requires antibiotic treatment. Treatment with rituximab is not a uniform reason to require antibiotics with surgical procedures unless your neurologist feels you are significantly immunosuppressed by your prior and current treatments. The dentist may ask your neurologist for clearance to proceed with the procedure and whether you require any antibiotics. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #MS #multiplesclerosis #rituximab
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Which medicine is the best for a man that has had Hepatitis B? Answer: Prior Hep B infections do not limit our ability to use any DMT. If there is risk of latent activation of the Hepatitis B virus based on serological and antigen testing and you are planning to take a high risk Immunosupressive treatment (e.g., anti-CD20 therapies including Rituximab, Ocrelizumab, Ofatumumab and ublituximab), you will need to take entecavir or tenofovir (both anti-viral therapies) while on anti-CD20 treatment for your MS and for up to 6 to 12 months after stopping anti-CD20 treatment. As always, please consult with your doctor. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego Here is My Question:
Do you need to get labs before each Ocrevus infusion? Answer: Labs obtained before Ocrelizumab infusions vary from clinician to clinician. All clinicians obtain a hepatitis B profile (some also obtain Hep C, HIV and TB testing) before starting treatment and usually basic labs (CBC with differential and complete metabolic profile). Some also obtain a baseline B cell count (less commonly an entire B cell subset analysis) and Immunoglobulin levels before starting treatment. After treatment with Ocrevus has started, some clinicians only obtain a CBC with differential before each subsequent infusion, while others check Immunoglobulin and B cell levels. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #Ocrevus #MS #multiplesclerosis Here is My Question:
I am taking Tecfidera for MS and my rheumatologist wants me to start taking Prolia for my Osteoporosis. My concern is that one of the possible side effects of Tecfidera is developing PML and I heard that a possible side effect of Prolia is also developing PML. Obviously, I don’t want to be on two drugs with the same serious side effect. Are you aware of any cases of PML associated with people on Tecfidera and Prolia? Thank you. Answer: I can find no evidence of linkage between Prolia (Denosumab) and PML in a PubMed search. The FDA adverse event reporting site lists cases of possible PML in a rare number of people on Prolia who were also taking medications known to be associated with the development of PML (e.g., Rituximab). This would not be considered a relevant relationship. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #Tecfidera #Prolia #PML #MS #multipleslcerosis Here is My Question:
What are the chances of relapsing with MS after surgical abortion if you take Vumerity before and after pregnancy? Answer: There is no data on risk of relapse after pregnancy termination with or without disease modifying agents. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #MS #multiplesclerosis #relapsingms #Vumerity #pregnancyandms |
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