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Here is My Question:
How long does Plegridy remain in your system once you stop? Answer: Plegridy’s half life is ~78 hours (meaning it takes 78 hours for the body to remove 50% of the Plegridy in your system). It is primarily removed by the kidneys, so if there is kidney disease, it may take longer. Given the half life of the drug, it is reasonable to assume it would take approximately 2 weeks to be removed from the body. A. Scott Nielsen MD MMSc Neurologist and MS Specialist at Kaiser Permanente Here is My Question:
I have RRMS and I’m on Ocrevus. I have had a lot of problems lately with symptoms. I had my second full dose of Ocrevus a week ago. My recent blood work showed a generally normal CBC with a WBC at the low edge but my monocytes % was elevated but only 11. Would this possibly have anything to do with my recent Ocrevus infusion? MS in general? Or is it something I should get looked into for other causes? I looked my labs over the last few years and my monocytes % have steadily increased and have been between 9-11 for a few years. I know it’s mild so I was wondering if I should have any concern outside of MS. Answer: Relative percentages of lymphocytes will change when using immunotherapy. The absolute numbers are more important. Mild elevations are not likely to be clinically meaningful. Keep in mind that symptomatic therapy is a different discussion than disease modifying therapy (ie, Ocrevus). A. Scott Nielsen MD MMSc Neurologist and MS Specialist for Kaiser Permanente Here is My Question:
Is This Banding Sensation in My Legs Due to MS? I know that banding, or girdling, sensations around the torso is a common symptom of MS, but can banding also be felt in the limbs? In the past, I have experienced numbness that started in both feet that began to creep up my legs. Eventually it felt as if I were wearing strange ankle socks or had ace bandages wrapped around my ankles. Over time, the slight constricting sensation would go away and reappear at times (often in the heat). The highest I’ve felt it is above both knees. It’s not painful, just a curious and annoying sensation. Answer: MS can produce sensory illusions of a banding sensation. These can be experienced in any location based on where in the nervous system MS has affected. Your neurologist can help determine if the location of your prior MS involvement mate neuroanatomical sense for the sensory illusions you experience. She/he can also help determine if there is a symptomatic treatment strategy if the symptoms are severe. A. Scott Nielsen MD MMSc Neurologist and MS Specialist at Kaiser Permanente Here is My Question:
Regarding my previous question about my 67 yr old husband stopping Ocrevus, I have another question. My husband has PPMS and with his progression he is now in a wheelchair and with not much change with his MRI (as I understand it)...is there a medication he could take? Not being the prescribing doctor and with this limited amount of history on my husband, I'd like to know your opinion on whether there is a med for him or not. Thank you. Answer: While there are no medications for your husband at this time, there are things that can be done to lessen his symptoms and improve his quality of life. These are topics to discuss further with your MS specialist. Good luck to you Revere (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:
I am writing this for my husband who is a 67 year old male diagnosed with MS in 2015. He has gone from a cane to a walker and now is total assist in a wheelchair. He also struggles with dysphagia and is demonstrating some dementia. He used to take Tecfidera and now has been on Ocrevus for the last year and 1/2. He is in need of a feeding tube but is refusing. His MS neurologist has suggested stopping Ocrevus, he says it could be doing him more harm than good since he is a good candidate for aspiration pneumonia and Ocrevus depletes your immune system. Should he not continue with the Ocrevus infusions? Thank you Answer: It would be difficult to justify treatment with Ocrevus for your husband based on the information you’ve provided. Specifically, 1. The clinical trials that led to approval of Ocrevus for progressive MS only included people under the age of 55. Your husband is significantly older. 2. The clinical trial that led to approval of Ocrevus for progressive MS only included people who were still ambulatory. Your husband is wheelchair bound with significant cognitive dysfunction and swallowing difficulty. 3. As you mentioned, your husband is at high risk of pneumonia. This risk will be increased by treatment with Ocrevus. All treatment decisions need to be personalized and directed by his physician. In this case I agree with his or her recommendation to stop treatment. Revere (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 vomit about 10 to 12 hours after taking Plegridy, so on my injection days I am eating so little that I feel weak. What should I do? Answer: Nausea and vomiting are not uncommon side effects with Plegridy, especially early in treatment. Your doctor will know if you have other medical problems or take other medications that may be contributing to this side effect. Your doctor will also be able to give you a medicine to prevent this side effect, if you continue on Plegridy. Revere (Rip) Kinkel MD Professor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego |
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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