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Tecfidera or Ocrelizumab?

Hello All. I have been recently diagnosed with MS and have been given various options for treatment. Two of the treatments that my consultant is suggesting is a choice of Tecfidera or Ocrelizumab. I am feeling a little overwhelmed and a little unsure. I have no idea which one i am going to choose. I have researched them quite a bit but i am still none the wiser. My symptoms over the last 6 months + have been - numbness in left hand and left leg, optic neuritis, dizzyness, tripping and failing a fair bit etc. This is every day. Any guidance would be very much welcomed!

Hello

Hmm, comparing those two drugs is difficult. They are really very different and yet both offer a relapse reduction rate of about 50%.

Tecfidera is an oral therapy, popping a couple of pills everyday. It has to be taken with food and makes some people feel a bit yuck until they are used to the drug. The way to combat this is to slow down the increase in strength of the drug. Generally you are given a half dose for week one then go straight onto the full dose for week 2 and onwards. If you were to have a larger number of the half dose, you could start with one half dose pill in week one, 2 half doses in week two, one full and one half dose in week 3 and go onto the full dose in week 4.

Tecfidera is supposed to be most effective when it’s the first DMD a person has been on, which makes it a good option to start with. It can cause side effects, low lymphocytes being quite common (which ultimately mean you have to stop the drug). But the side effects are easily recovered from.

Ocrelizumab (Ocrevus) is a different kettle of fish. It’s so new that anecdotal views are hard to come by. I personally don’t know enough about the drug except to say that 1) it’s a 6 monthly infusion so appears to be quite straightforward in terms of how it affects your life, 2) the first dose is split in two, presumably so any side effects can be minimised and if you had a really bad reaction, you wouldn’t have the second half, 3) if you did have bad side effects after the first 2 infusions, it might take longer to recover from the effects.

In all honesty, I know so little about Ocrevus, that I couldn’t even start to say I’d pick one over the other. Really, you’d have to go by the opinions of your neurologist and MS nurse. You could also have a look at https://www.mstrust.org.uk/about-ms/ms-treatments/ms-decisions-aid so at least you’ve got a better idea about the two drugs.

You could also have a look at https://shift.ms/ There are many more Ocrevus (and Tecfidera plus all the other DMDs) on that site.

Best of luck with whatever you decide on. Let us know what you choose and how it’s working out.

Sue