should I consider ocrevus if i have secondary progressive ms with relapses?

Here is My Question:
What is the common thinking about the use of Ocrevus in older patients? I’m almost 61 and due to get my first infusion soon. My neurologist, whose idea it was for me to go on Ocrevus in the first place, said he’s not planning to keep me on it for more than a couple of years due to my age. I don’t see the point of even going on Ocrevus then if I’m not going to be allowed to stay on it even if it’s helping me and I can tolerate it. Is long term use of Ocrevus considered unsafe in older people? Or ineffective? What benefit would I get from just a few infusions? I feel too discouraged now to even start it. Should add that I’m secondary progressive with relapses.

Answer:
If you are indeed in the progressive phase with relapses, then you are a good candidate for this therapy as it is one that has shown the ability to slow down the rate of progressive disability. The argument to treat is rooted in the fact that once the door on the inflammatory phase is closed (ie, no evidence of relapses or changes on the MRI), there is no therapy that has proven able to modify the rate of accumulating disability. The thought that an individual does not require indefinite treatment is based on the same rationale:  the inflammatory phase eventually ends for everyone, and when that time comes, there is no real justification for continued exposure to these therapies (as the are currently constituted at the time of this response). The challenge is concluding when that door closes for the individual patient.  That’s hard to predict.

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