Q&A 100: Comparing DMTs

Should I change my decision and switch to Ocrevus (ocrelizumab) instead?

Case

I am a 52-year-old woman who has been on Natalizumba for 12 years. Sadly, I have become JCV seropositive and was recommended to move to another disease-modifying therapy. I was offered oral cladribine (Mavenclad) and ocrelizumab (Ocrevus). Last week, I selected Mavenclad to change to (from Tyruko) as it doesn’t seem to have too many side effects. I consulted the MS Trust website on MS drugs with summarised information about these. I noticed that Mavenclad appears to be quite a lot less effective than Tysabri, Tyruko and Ocrevus (with no mention of Briumvi in their A-Z guide (presumably because this is a relatively new DMT?):

Clinical trial data suggest that Mavenclad reduces the number of relapses by around 58%.

• You take Tysabri as an intravenous infusion (drip) once every four weeks to reduce the number and severity of relapses. It reduces the number of relapses by about two-thirds (70%).

• You take Tyruko as an intravenous infusion (drip) once every four weeks to reduce the number and severity of relapses. It reduces the number of relapses by about two-thirds (70%).

• You take Ocrevus every six months, either by infusion (drip) into a vein, or by an injection under the skin. In relapsing remitting MS, it reduces the number of relapses by about two thirds (70%). In early, inflammatory primary progressive MS, it slows the worsening of disability.

Should I change my decision and switch to Ocrevus (ocrelizumab) instead?

NOTE: General Substack newsletters and the microsite are free; only Q&A sessions are restricted to paying subscribers. I can't run and maintain the MS-Selfie microsite, so I must pay people to help me do the work. If people want to ask medical questions unrelated to the Newsletters or Podcasts, they either need to become paying subscribers or email (ms-selfie@giovannoni.net) to request a complimentary subscription.

Prof G’s answers