Is Ocrevus more effective than Tysabri?

Here is My Question:
Now that Ocrevus has been out for a while and we have more information, do you think it is more effective than Tysabri? I recently read a study saying Ocrevus and stem cell transplant were similar in efficacy. The authors cautioned that there was only 3 years of data. Still, pretty impressive. Also, what is the risk of jc positive person transitioning from Tysabri to Ocrevus in regards to PML? I know there should be a MRI before starting Ocrevus.

Answer:
There are no randomized head-to-head comparisons of Ocrevus and Tysabri adequately powered to answer your question. Smaller observational comparisons suggest little difference in comparative efficacy in people with relapsing remitting MS. Both therapies compare well to the efficacy of Hematopoietic Stem Cell Transplant (HSCT), but with far fewer risks and side effects. 

Many JCV positive people with MS eventually switch form Tysabri to Ocrelizumab (Ocrevus), Rituximab, Ofatumumab (Kesimpta) or Ublituximab (Briumvi); in fact, the most favored treatment option after discontinuing Tysabri is treatment with one of these anti-CD20 monoclonal antibody therapies. Before switching it is important to exclude pre-symptomatic PML with a repeat MRI scan. Switching to an anti-CD20 therapy also dramatically reduces the risk of a rebound relapse after stopping Tysabri.

Revere P (Rip) Kinkel, MDProfessor of Neurosciences
Director of the Multiple Sclerosis Program
University of California San Diego​
#multiplesclerosis #MS #Ocrevus #Tysabri