should my husband stop taking ocrevus?

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.