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Question: Can you look at case studies for dupixent in MS and comment on them?
Answer: Dupilumab (Brand name Dupixent) was approved for the treatment of atopic dermatitis (i.e. eczema) refractory to topical therapies (i.e. applied to the skin) in 2017 and for adjunctive treatment of asthma in 2018. It is also indicated for treatment of chronic rhinosinusitis with nasal polyposis, eosinophilic esophagitis and prurigo nodularis (another skin condition). Dupilumab is a monoclonal antibody therapy that inhibits signaling of 2 cytokines (IL-4 and IL-13) known to be associated with these aforementioned conditions. According to recent posts by the manufacturer (Regeneron) there are over 800,000 people treated with Dupixent worldwide. The current FDA package insert does NOT include any warnings regarding the use of Dupixent in people with multiple sclerosis. A review of the literature in PubMed reveals 5 case reports (3 in a single publication) since 2021 of the use of Dupixent in people with MS. Case report 1 (Laageide L et al. JAAD Case Reports 2021 Sep; 15: 33–35) describes a 34-year-old woman with undiagnosed multiple sclerosis for a year who began Dupixent 2 months before an MS relapse and 4 months before her Multiple Sclerosis Diagnosis. She was not on a disease modifying therapy until after her diagnosis with MS . Dupixent was stopped and her MS was controlled with ocrelizumab. Case report 2 (Gelato F et al. Dermatol Ther 2022 Oct;35(10):e15740)doi: 10.1111/dth.15740)) describes a 21-year-old with severe atopic dermatitis started on Dupilumab in January 2019 with excellent results. However, after 1 ½ years on Dupilumab treatment he began to experience symptoms of multiple sclerosis (onset July 2020) which was diagnosed in September 2020. Treatment with dupilumab was stopped and his multiple sclerosis was controlled with natalizumab (Tysabri) Case report 3 (Esposito M, et al. JAAD Case Reports 2022 Nov 5:31:1-5. doi: 10.1016/j.jdcr.2022.10.031) describes three people with well-established MS, ages 47, 53 and 60, who received Dupixent for atopic dermatitis while receiving teriflunomide (brand name Aubagio) to treat their Multiple Sclerosis. None of the patients experienced a relapse or worsening of MS symptoms on Dupixent and their MRI scans remained stable. The authors of case reports 1 and 2 advised caution when using Dupilumab in people with MS. They hypothesized that inhibition of Th2 responses through inhibition of IL-4 signaling in susceptible individuals may aggravate Th17 mediated immune responses commonly associated with certain forms of autoimmunity including MS. It is important to note that both case reports 1 and 2 describe young, undiagnosed people with MS who started dupilumab before starting a disease modifying therapy for MS. In contrast Case report 3 described no significant adverse consequences of prescribing dupilumab in three older MS patients already on a DMT treatment. What conclusions can we draw from these case reports?
Professor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego PLEASE NOTE: This information/opinions on this site should be used as an information source only. This information does not create any patient-HCP relationship, and should not be used as a substitute for professional diagnosis and treatment. Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition. #Dupixent #multiplesclerosis Here is My Question:
I got Rituximab 1st dose of 1gm, yesterday (18 March' 24) for MS, and 2nd dose is scheduled after 14 days, so what can I take on my end to improve, like any supplement or multivitamin? Answer: You've already started on an excellent treatment for relapsing MS, so you're off to a great start. A full program for managing any chronic neurologic disease requires a long-term plan of self-management. This plan will vary depending on your particular circumstances but must include the following:
Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego Here is My Question:
How do you determine if your MS symptoms are not from cervical spondylosis, cervical herniated disc, or kyphosis? I have a lot of cervical issues that have not been addressed and was only given MRI. I read that cervical issues could cause white matter changes in MRI. I also experience menstrual migraines. How do I know if my diagnosis is correct? Answer: It can be difficult to determine the cause of spinal cord symptoms, also called a myelopathy, particularly when the symptoms occur in middle aged or elderly individuals. Both degenerative disc disease and arthritis involving the cervical spine increase with age and may cause some impingement or frank compression of the spinal cord. Whether this compression causes any symptoms depends on how quickly it develops and whether there is compression of blood flow to the spinal cord. MRI scans can determine the degree of spinal cord compression and occasionally determine if there is limitation of blood flow or a contusion in the spinal cord. More commonly, we are able to see narrowing of the spinal cord canal space and flattening of the spinal cord at one or more levels but without any other alterations in the imaging characteristics of the spinal cord. In these cases, it takes a skilled neurologist using features of your history and examination to determine the likelihood that the compression observed on the MRI scan is responsible for your symptoms. This is most difficult in cases where there is also obvious involvement of the spinal cord by a disease such as multiple sclerosis. Some things to consider are the following:
Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #multiplesclerosis Here is My Question:
At the time of my diagnosis (In 2021 at age 63) I agreed to treat my active RRMS (13 oligclonal bands) w/ 6 week EID Natalizumab. At 21 months, NRBCs started increasing. Why is erythroblastaemia a frequent finding of natalizumab treatment in RRMS patients, will it continue for the duration of Natalizumab treatment and are there any known complications of having elevated NRBCs? Answer: Thanks for your question. Elevated NRBCs (nucleated red blood cells) and WBCs (White blood cells) are common in people treated with Natalizumab (Tysabri). There are no known adverse effects from these elevations in common blood counts after nearly 20 years of treatment with this monoclonal antibody. The circulating cells are normal in function and morphology and seem to reflect increased mobilization of hematopoietic stem cells. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #multiplesclerosis #RRMS Here is My Question:
I have MS and when I tested to see what medicines would be good for me, I tested for JCV with an index of 3.59, and my doctor told me that I should do Ocreveus infusions every 6 months. Would doing those infusions cause those numbers to go up any, because she was concerned at first because she said she has never seen numbers that high before for JCV. I'm also afraid I'm being misdiagnosed with MS as my bloodwork was negative and so was my spinal tap and she was confused on why, but continued to say it was MS because of the 20+ white matters on my brain. She said she's shocked I'm not in a wheelchair but I'm probably about the healthiest patient she had she said. She won't test my blood anymore because she tested 2 more times after that and it hasn't gone up. I've done the 2 treatments of Ocreveus 2 weeks apart at the 300 mg and now every 6 months at 600 mg and so I've only done 2 of the 600 mg ones. Should I be potentially worried about not getting bloodwork done for JCV anymore? She said the only way I'd do bloodwork again for it is if my MRI changes, but I have braces so there is a lot of artifact and could potentially cause something to be missed. Thank you in advance. Answer: Thanks for your message. It seems that without further information I am able to comment on two issues you raise First, it is not uncommon to see a JCV index > 3.0. This only means you should avoid prolonged treatment with Tysabri. It has no bearing on your risk of complications (i.e. PML) on Ocrevus Second, you do not seem convinced that you have MS. It is important for your decision making and your well-being to have confidence in this diagnosis. It is perfectly appropriate to ask for a second opinion from another MS expect to obtain this reassurance. Ocrevus is a great therapy but with rare serious long-term risks (like most treatments). You do not want to be on an inappropriate and unnecessary treatment. For your information, some people with MS do eventually have spinal fluid abnormalities with repeat testing and white matter lesions have very little cross-sectional correlation with disability. These facts should not be a surprise to an MS specialist. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #multiplesclerosis #MS PLEASE NOTE: This information/opinions on this site should be used as an information source only. This information does not create any patient-HCP relationship, and should not be used as a substitute for professional diagnosis and treatment. Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition. Here is My Question:
Hi there. Love reading all of your posts. Truly helpful. I’ve been on and off Tysabri since 2015. I have been off during my 3 pregnancies. The first 2 postpartum experiences were great. The last postpartum period I experienced a lot of small new brain lesions. After resuming Tysabri for 6 months I had stable MRIs once again. Since my diagnosis in 2014 my entire Cspine has lesions (very scary) along with a few in my t spine. And more recently more brain lesions, initially I only had a few in the brain. I have been quite well despite all of this. Like I said-birthing my 3 children and nursing them well after 2 years old! I am extremely active and have minimal symptoms. Do you have patients with many spinal lesions who still do very well? My next question is- if I switch to Ocrevus do you think I will be worse off than I have been on Tysabri? I just got a positive JCV of .75. If I switch to Ocrevus I worry it will not be as effective. I’m very nervous. My neurologist thinks it will just fine for me. Thank you so much! Answer: There are really 3 issues involved with your decision making:
First, based on your report, your only disease activity (by MRI only) occurred after stopping Tysabri for pregnancy. This is expected and not a sign of breakthrough disease or treatment failure. Second, you do have an increased risk of PML and this risk is probably too high if you have received an immunosuppressant treatment in the past. If this is the case, you should probably stop Tysabri now. If you have received prior immunosuppressive therapies or chemotherapies, you can probably lower your risk of PML to an acceptable range by more frequent MRI monitoring (every 6-12 months with no contrast needed and just brain imaging) and increasing the interval between infusions from every 28 days to every 42 days. We know from a prior study that the efficacy of Tysabri is the same when administered every 42 days after a year of treatment given every 28 days. Third, Ocrevus has its own set of serious risks, mostly increased infections, particularly with prolonged treatment. We do not know if it is more effective than Tysabri because there has not been a head-to-head clinical trial and it is not possible to compare the trial results. Lastly, anecdotally patients do report feeling better on Tysabri and often tell us this feeling disappears after stopping Tysabri and starting Ocrelizumab. I would not weight this information too strongly because of the usual bias in these anecdotal reports. We less often know of people stitching from Ocrevus to Tysabri so we do not know if these individuals would report the same improvement in symptoms or well-being. I hope this helps with your decision making. Remember, there are specific reasons your MS specialist may want to switch you to Ocrevus that we are not aware of based on your message. For one thing, many specialists feel uncomfortable treating people with MS who are JCV index positive. This is understandable if there are other excellent therapies available without significant risks. Unfortunately, all therapies have risks; we want to ensure that the benefits of a therapy out weight the potential risks and you are aware of the risks for informed decisions. PLEASE NOTE: This information/opinions on this site should be used as an information source only. This information does not create any patient-HCP relationship, and should not be used as a substitute for professional diagnosis and treatment. Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #multiplesclerosis #MS #Ocrevus #Tysabri #PML Here is My Question:
My husband has been on Gilenya for about 5 years. He will now go on Kesimpta. We will be trying for a baby soon. Does Kesimpta affect male sperm/fertility? I understand there is not much research but I need some sort of reassurance. Thank you. Answer: We have no data on the effects of Kesimpta on male fertility. We do have data showing that another drug (Ocrelizumab) with the same mechanism of action--targeting and depletion of anti-CD20 positive B cells--does not affect gonadal hormone levels or sperm function after 12 months of therapy. It is more likely that medications used to treat MS related symptoms (anti-depressants and anti-spasticity medications) may negatively affect both sexual function and male fertility and men should continue the risks and benefits of continuing these drug therapies during pregnancy. Among the disease modifying therapies Ocrelizumab (Ocrevus), Rituximab, Ofatumumab (Kesimpta), Natalizumab (Tysabri), Dimethyfumarate, S1P modulators (Fingolimod, zeposia and Mayzent) , interferons and glatiramer acetate have no specific warnings for men trying to conceive. There are very specific warnings and precautions for men on Teriflunomide (aubagio), Cladribine (Mavenclad), Mitoxantrone (lemtrada), azathioprine, methotrexate and cyclophosphamide trying to conceive. These drugs must be stopped for specific periods of time or sometimes avoided until the man donates to a sperm bank if he wishes to conceive in the future. I hope this helps. In general, most neurologists and patients do not consider these issues in their male patients except as mentioned in the last paragraph, primarily because there is so little data available to raise any concerns. You can be thankful that there is at least some data available to guide you on the anti-CD20 class of medications and this data seems reassuring. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #multiplesclerosis #MS Here is My Question:
What are your thoughts about walking on a treadmill to help with gait? Answer: Treadmills are commonly used to improve gait in people with MS and other conditions that affect ambulation. This can be done with or without a harness supporting your body depending on the severity of your walking difficulty. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #treadmillsandMS #MS #multiplesclerosis If i forgot to take my Tecfidera pills last night, can I take my normal dose the next morning?3/28/2024
Here is My Question:
I accidentally took 2 of my Tecfidera pills. Can I take my normal Tecfidera pill the next morning or should I skip and wait till night one? Answer: If you accidentally take 2 Tecfidera tablets with your morning dose, it is okay to take 1 tablet in the evening and get back on the correct schedule the next day (1 capsule twice a day) Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #Tecfidera #MS #multiplesclerosis Here is My Question:
I've been on Gilenya for 6 years now and it has increased my liver ALT and AST enzymes. My neurologist suggests switching to Kesimpta, which is not available in adequate quantities right now, so he suggested switching to Tecfidera. However, based on my research over the internet, I've found that Tecfidera needs 24 weeks to start working and 2 years to full effect, while stopping Gilenya can cause a severe relapse in 12 weeks in some cases. Will taking Tecfidera leave me without protection during this period of time till it starts to work? Thank you. Answer: Whenever a person with relapsing MS switches from either an S1P modulator (e.g., mostly Gilenya but theoretically Zeposia and ponesimod) or Natalizumab (Tysabri) to another DMT, neurologists must be mindful of the potential for a rebound in disease activity. This tends to occur faster (8 weeks or later) with S1P modulators than with natalizumab (12 weeks or later) and overall occurs in about one third of MS patients. The Restore study suggested that IV steroids, glatiramer acetate and interferons begun after stopping Natalizumab were not effective at preventing rebound activity. However, a single infusion of anti-CD20 therapy (e.g., Rituximab or Ocrevus) after stopping either S1P modulators or Natalizumab is very effective at preventing rebound disease activity. I am not aware of data showing Tecfidera to be effective at preventing rebound in this circumstance. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #multiplesclerosis #MS #Gilenya #Tecfidera Here is My Question:
Greetings. I have a question for you. In 2018, I tested positive for JCV and the index showed 0.38. Since then, the status has been negative. I started with Kesimpta therapy. I took Ocrevus for three years, now Kesimpta. My question is whether it is possible to develop PML. And how is it possible that the JCV status positive index 0.38 in 2018 was negative all this year. Thank you in advance for your answer. Answer: PML is uncommon in people with MS on anti-CD20 therapy (e.g., rituximab, ocrelizumab, ublituximab and ofatumumab). In fact, it is very uncommon on all MS therapies including natalizumab. There is no current way to stratify or assess the risk of PML in people on anti-CD20 therapy. The only exception is people with MS who recently stopped natalizumab and started an anti-CD20 therapy. They must first be assessed for evidence of asymptomatic PML before starting anti-CD20 therapy to prevent a carry-over case of PML. There is also reason to believe that significantly immunosuppressed individuals on anti-CD20 therapy may have an increased risk of PML. We use the JCV index to stratify risk of PML in people on Natalizumab (Tysabri) only; There is no data I am aware of that would allow us to use the JCV index to assess the risk of PML with other therapies. People with low titer JCV index not uncommonly bounce back and forth between a negative result and a very low titer response with repeated testing. Most of the risk of PML in people on natalizumab occurs in people with high titers. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #PML #multiplesclerosis #JCV Here is My Question:
Hello! I am not diagnosed with MS but I take Tecfidera twice a day as a prevention (I had lesions in my brain that the Tecfidera medicine made disappear because they were caught early) and I never had an attack. I'm on the preventive side (my dad and grandma both have MS). I want to do fillers for both my face and my back ( I have a small whole I want to fill where I used to have a mole). Is it safe to do fillers while taking Tecfidera? thank you Answer: I know of no contraindication between any of the fumarates, including Tecfidera, and the use of fillers. Tecfidera is indicated for relapsing forms of MS including clinically isolated syndrome. I assume you are taking it because of a prior clinically isolated syndrome. Please check with your physician as this is strictly for education purposes. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #tecfidera #fillers #multiplesclerosis PLEASE NOTE: This information/opinions on this site should be used as an information source only. This information does not create any patient-HCP relationship, and should not be used as a substitute for professional diagnosis and treatment. Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition. Here is My Question:
I've been taking Tysabri for a year and a half and have always been JCV negative. Just got back results positive .45. When do you recommend I retest blood to make sure no upward trend? How fast can index potentially rise from .4 to .6? .... Answer: Great question. Since January 2012 when the JCV index became widely available to assess risk of PML on Tysabri, only 2 patients who were anti-JCV Ab negative at baseline (like yourself) out of total of 34,379 patients negative at baseline developed PML. This data can also be converted to a PML incidence rate of 0.058 per 1000 patients or 1 case of PML per 17,000 people treated in patients who were anti-JCV Ab negative at baseline (before starting Tysabri) . This is regardless of whether patients subsequently turned JCV index positive. While this news is reassuring, it doesn't directly answer your question. Clearly, the risk of PML will go up in people who become JCV Index positivee and requires more frequent testing to assess this risk over time. For people, like yourself, with low titer positive conversion (usually, this includes index levels between 0.4 and 0.9), we often recommend switching to every 6-week infusions and repeat JCV index testing every 3 months. There is randomized clinical trial data that 6-week infusions are as beneficial as 4-week infusions in people who go on extended interval dosing after a year of Tysabri monthly treatment; there is also data derived from the TOUCH registry that extended interval dosing reduces the risk of PML. Therefore, we also usually recommend switching to every 6-week infusions of Tysabri. If your JCV index rises above 1.0 (many specialists have a different JCV index cut off levels for stopping Tysabri, but this is mine) with continued JCV index monitoring, we often recommend switching to another DMT, often an anti-CD20 therapy (i.e., Ocrevus, Briumvi, Rituximab or Kesimpta) after ensuring there is no evidence of pre-symptomatic PML by repeat MRI prior to starting the new therapy. Hope this information helps with your discussions with your doctor and your ultimate decision. As usual the ultimate recommendation by your MD may depend on additional information we are not aware of such as your prior use of immunosuppressant therapies, age, disease type or co-morbidities. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #Tysabri #multiplesclerosis #JCVindex Here is My Question:
I’ve recently started getting cramps in my feet. At first the weren’t bad but now it feels like someone crushing my foot. I’m on a mild muscle relaxer but it works a little. Answer: For the purpose of answering this question I will assume you have Multiple Sclerosis and no other problems associated with either cramps or spasms. There are three basic principles to follow for relieving muscle spasms in particular muscle groups.
Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #footcrampsandms #MS #multiplesclerosis #footcramp Here is My Question:
I don't have a diagnosis of MS, but am having multiple symptoms that make me worried I might have this condition. I don't have health insurance so I can't see a doctor unless I can really justify sinking thousands of dollars into testing. I was just wondering if these symptoms are concerning so I can be sure it's worth going into medical debt to get checked out. At first I thought this was probably just a pinched nerve or something but I have been in constant pain/discomfort for over three months so I'm starting to get worried that this is something else. Here is a (very long, so sorry) list of my symptoms: - pain in upper back between my shoulder blades going down left arm. The pain is burning, stabbing, or shocking (though sometimes is a persistent deep aching) and sometimes I can feel the muscles in the neck/back/shoulder contracting (feels like "locking up") and becoming hard and painful. Worst overnight and right after waking up in the morning. -Tried ice, heat, icyhot, massage, rest, Tylenol, ibuprofen, stretching, etc. But nothing has helped -I can feel a nerve pulling when I try to look down, bend down, turn my head, or move my arm. I cannot tilt my head back to look up at the ceiling. Sometimes it just hurts but other times I physically can't do it and need to tilt my head with my hands. At it's worst I also need to physically tilt my head to the side or turn my head down with my hands. -with both the pain from my muscles and the nerve pulling sensation, my body jolts forward slightly when I feel them, almost like wincing but more pronounced. It usually stops after a few seconds. -If it's not pain then it's numbness and tingling and generally uncomfortable. 24/7. It never stops. It just gets either better or worse depending on the day/week. -I can't sleep for more than a couple of hours at a time because there is no comfortable position to be in, no matter if it's standing or sitting or laying down. The pain isn't unbearable (though at times I couldn't even raise myself up to get out of bed and had to have my wife physically lift me out of bed, so the worst of it comes and goes). -even though I do have strength in my left arm it feels weaker than usual and gets fatigued almost immediately when I raise it up, or I can't lift/grip things as easily when my muscles do that contracting thing, due to pain. Example: I couldn't lift a pan out of the sink this morning with my left arm but could with my right. (this post was shortened as it is unable to fit due to word length constraint) Answer: Thank you for the in-depth observation of your symptoms. The diagnostic process in neurology is complex and depends a great deal on your age, past medical, surgical and family history and examination; but at a minimum it sounds like you have a problem involving the lower part of your cervical spine on the left side. This could be as simple as arthritis or a disc compressing a nerve root or even the spinal cord, or as complex as MS or even a tumor. Most of the common causes I've mentioned are very treatable, especially when evaluated early before the condition progresses too much. It is not too late to purchase health insurance on the exchange in your state or sign up for Medicaid if you fall under the income limit. Open enrollment through the affordable care act is underway until the middle of December, so you will need to hurry. For Medicaid you can sign up at any time during the year. Neither option will exclude you because of a pre-existing condition. Good luck Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego Here is My Question:
I was recently diagnosed with MS my MRI shows 2 lesions and my CFS OLIGOCLONAL BAND PROFILE shows 4 bands and abnormal, what stage is this? Answer: We currently stage MS by clinical criteria (see below), not by MRI or CSF results. MRI and CSF results are used for diagnosis and prognostication. Most people newly diagnosed with MS under the age of 40 have relapsing MS and those over 40 have a mix of relapsing and progressive forms of MS. Relapsing MS is characterized by acute or subacute onset of new neurological symptoms and findings consistent with MS that variably improve over weeks to months. 80 % of people with MS relapses reach their nadir (worse point) within 2 weeks and 90 % within 4 weeks. Improvement typically takes 3 to 6 months following a relapse. Progressive MS is characterized by steadily worsening neurological symptoms and findings over a year or more without remission Two lesions on an MRI of the brain would be considered a low lesion burden. Similarly, 4 oligoclonal bands in cerebrospinal fluid (CSF) would not be considered an additional risk factor for subsequent disease worsening, although this finding is certainly useful for assisting in the diagnosis of MS. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #multiplesclerosis Here is My Question:
What do you think about taking Duavee as hormone replacement therapy in MS patients? I have an early onset menopause, and have come across some research about Duavee. Thanks! Answer: We have no current information about the use of Duavee in menopausal women with MS at this time. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego I'm getting a Tattoo on Saturday and Starting Kesimpta treatment last Friday. Is this OK?12/10/2023 Here is My Question:
I started Kesimpta treatment last Friday, I’m due to inject this Friday, can I have a small tattoo done on Saturday. Answer: I see no reason to delay your Kesimpta injection because of a tattoo, but as always check with your physician. I would not inject at the tattoo site. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #tattooandmultiplesclerosis #MStattoo #tattooandMS #MS #multiplesclerosis #Kesimpta PLEASE NOTE: This information/opinions on this site should be used as an information source only. This information does not create any patient-HCP relationship, and should not be used as a substitute for professional diagnosis and treatment. Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition. Here is My Question:
I have been on Ocrevus for 2.5 yrs now. About 8 weeks prior to each infusion, my physician has me complete a set of labs. The labs are usually things like Vitamin D, IGg, WBC, RBC, etc. They also require a urinalysis. The urinalysis is what I am curious about. What are they looking for with that? Infection? What things are typically checked prior to an infusion of Ocrevus? Answer: I would ask your physician what she or he is looking for in any test they order. If the test is not easily explainable there is no reason for the test. We usually obtain a urinalysis to check for infection although I do not do this testing prior to Ocrevus infusions unless I suspect an infection. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #multiplesclerosis #MS #Ocrevus |
PLEASE NOTE: This information/opinions on this site should be used as an information source only. This information does not create any patient-HCP relationship, and should not be used as a substitute for professional diagnosis and treatment. Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition.
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