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Q&A 26: Anti-CD20 therapy, hypogammaglobulinaemia and infection risk
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Q&A 26: Anti-CD20 therapy, hypogammaglobulinaemia and infection risk

I have hypogammaglobulinaemia; should I switch from ocrelizumab to teriflunomide? Does intermittent fasting increase your mortality? Will moving to a sunny country help my MS? ...
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Questions

Q1: I am 36 years of age and have now been on ocrelizumab for over six years.  I am doing well on ocrelizumab with no relapses and a stable MRI. I also don’t think I have smouldering MS. However, my latest blood results show I have developed hypogammaglobulinaemia, and my neurologist now wants to switch me from ocrelizumab to teriflunomide. Do you agree with this? 

Q2: I have just read that intermittent fasting (IF) increases your mortality due to cardiovascular disease. Is this correct? Should I stop IF? 

Q3:  I am writing on behalf of my 16-year-old daughter, who was diagnosed with MS earlier this year. She has been put on ocrelizumab (Ocrevus). I want your opinion on whether moving to a sunny country further south of Europe, like Italy, would help with the disease's progression and severity.

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Answers

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