Here is My Question:
I have been on Tysabri for RRMS for about 9 years. Slowly my symptoms have worsened especially my short term memory and cognitive issues, paresthesias, fatigue and depression.
Recently my world renowned neurologist said to switch over to Ocrevus, known for success with primary progress MS by the Opera1 and Opera2 studies but I have not found any studies comparing Ocrevus with Tysabri for RRMS.
Another world renowned neurologist here in NY switched her female patient to Ocrevus who has RRMS with exactly the same symptoms as I do.
Her symptoms are now gone after 1 year!
I have only had the first 2 half infusions of Ocrevus without reactions or benefit. Now my neurologist has switched me back to Tysabri. Any idea why? Any study showing Ocrevus being better than Tysabri in RRMS? Our lab work is essentially the same.
You are correct that there is no data of comparison.
On caution I would have is the fact that you were exposed to Ocrevus (which would give you one of the risk factors for PML among Tysabri users.... Ocrevus is cytotoxic).
Not sure why the switch back to Tysabri. You would need to review this with your neurologist who has more of the facts about you on hand.
Keep in mind that Tysabri, Ocrevus, etc...do not treat symptoms. They were never tested as a symptomatic therapy, so I would be very cautious in making any disease modifying therapy changes due to symptoms (transition should be based on new relapses, changes on MRI, or progressive disability).
A. Scott Nielsen MD MMSc
Neurologist and MS Specialist at Kaiser Permanente
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