…s discontinued, most would switch to ocrelizumab (70%). Natalizumab: Would commonly be used after fingolimod (40%). After stopping natalizumab, most would switch to ocrelizumab (63%). Ocrelizumab: Commonly used in patients previously treated with fingolimod (42%). After discontinuing, many would switch to alemtuzumab (44%). Alemtuzumab: Often preferred in patients after ocrelizumab (33%). If another therapy were needed, many would switch to ocreli…
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…:2787-2799; free full text at www.ncbi.nlm.nih.gov/pmc/articles/PMC6736181/pdf/awz212.pdf). “Silent progression” describes the worsening disability that occurs independently of relapses or white-matter lesions and which appears to be correlated with brain atrophy (Cree et al. Ann Neurol 2019;85: 653–666). In contrast, PIRA does not take into account MRI activity. The term originated in an analysis of data from the Tysabri Observational Program (TO…
…in global sales in 2018 and was expected to earn over $4 billion in 2019 (www.roche.com/investors.htm). But it has not been all sunny days. A number of safety concerns have emerged with higher-efficacy DMTs. The FDA required a label change to Lemtrada in January following case reports of intracerebral hemorrhage (Rare cases of stroke reported with alemtuzumab, NeuroSens, December 14, 2018). Hypogammaglobulinemia has been reported in a subset of p…
…les (reviewed in Mills et al. Mult Scler 2018;24: 1014-1102; free full text at www.ncbi.nlm.nih.gov/pmc/articles/PMC6013383/pdf/nihms961288.pdf)….
