Question
I am a 50-year-old woman who was diagnosed with MS in Sept 2020 after I was hospitalised with a suspected stroke. I had lost the use of my right side of my body and had forgotten my name/address, etc. In the hospital, I had an MRI, which showed lesions plus a spinal tap.
After I was discharged, the neurologist suggested a ‘wait and see’ approach re going on an MS disease-modifying treatment (DMT). After two more relapses, including vertigo plus general decline, my neuro wanted to put me on Tysabri in 2022. However, my JC levels were too high. I then went on Ocrevus, three or four cycles, but each time struggled with side effects during the infusions (feeling sick, dizzy, racing heart). After the infusion, I also had pain in my bones and recurrent infections - chest and many UTI’s.
Another MRI revealed spinal lesions in September 2024. I started Kesimpta. Again, I had side effects: flushing, heart palpitations, pain - so we stopped. My neuro is now suggesting Mavenclad (cladribine). At the same time, my kidney function has deteriorated. The doctor said I am currently at Stage 2, on the border of Stage 1.
I am really nervous about starting another DMT and having to endure all the side effects. At the same time, my MS is definitely getting worse. I would really appreciate your advice on which DMT you think would work for me.
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Prof G’s response
Wow, there is a lot to unpack here. I will start at the top and move down the list.
