What are the treatment options after Aubagio failure in MS?

Question

Hello doctor,

My brother is 42 years old, and he just failed his first-line MS treatment with Aubagio. His lymphocytes are critically low at 0.3, liver enzymes are four times higher than normal, and he has developed blood pressure issues. His neurologist wants to try Ocrevus next, but we are worried about more immune suppression. What are our options?

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have read your query and can understand your concern.

Aubagio is a selective immunosuppressant. Aubagio's long-term side effects are liver damage, elevations of blood pressure (BP), and a drop in the blood count. So contact your doctor to stop the medication and shift to another line of treatment.

Ocrevus is a CD20 monoclonal antibody that sticks to B cells, causing self-destruction or disintegration. This helps to kill them and stop them from getting into the brain or the spinal cord as they attack their myelin coverings. This reaction helps prevent inflammation and damage to the brain. It does not suppress immunity.

Other effective drugs could also be used with fewer side effects, such as Cladribine tablets, Tysabri, and Kesimpta.

The Probable Causes: Side effects of long-term treatment with Aubagio.

Investigations to be done: Ask the specialist to shift to suitable alternatives.

Treatment plan: Ocrevus, Cladribine, Tysabri, or Kesimpta.

I hope I have answered your query.

Let me know if I can assist you further.

Thank you.