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@jochad1 

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jochad1

Ocrevus and constant infections

Hi, I’ve been on Ocrevus about 3 years and was about to have my 7th Infusion. Everything stable. The trouble is, I am constantly having to take steroids for chest infections (asthma), but I also have had an outbreak of multiple HSV all over my chin since end of Feb. Originally they thought Shingles but despite continual oral Aciclovir for weeks, still the spots come. I am not having my Infusion next week, and would like to stop a treatment which is immunosuppressant like Ocrevus. Also have a 2 hour commute to work each way, plus work in healthcare. Is there a drug which would be more suitable? Am JC + as well.
Southend-on-Sea, United Kingdom
1
@mellowmedusa
@mellowmedusa
 

It's likely your herpes rash is caused by a combination of Ocrevus and the frequent steroids (I get that the chest infections that are causing you to have to take steroids are likely Ocrevus related). Minimising steroids (if you can) would be the best idea. There are limited 'good' options. One is taking a less efficacious drug orally such as Tecfidera? Or aubagio. It is 'moderately' effective but is much less immunosuppressing. Your other options would be: - Continue on ocrelizumab but at reduced frequency - 9 monthly to yearly - Immunoglobulin infusions along side ocrelizumab (your neurologist will have to advise you if your Ig is low/normal but if you're getting such frequent infections, decent chance it is) - Tysabri seems a little risky if you're JCV+ AND prone to frequent infections. But again, can be given at extended interval dosing to decrease risk. Sounds like one to be discussed with your MS nurse or neurologist. Lastly, are reasonable adjustments, redeployment or changing job options - if you work in an environment which makes you more vulnerable?