Aubagio for Multiple Sclerosis Explained by Neurologist Dr. Brandon Beaber

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My book "Resilience in the Face of Multiple Sclerosis" on Amazon: www.amazon.com/dp/B07WP7H5LK
Dr. Brandon Beaber is a board-certified neurologist with subspecialty training in multiple sclerosis and other immunological diseases of the nervous system. He is a partner in the Southern California Permanente Medical Group and practices in Downey, California (South Los Angeles). He has several publications on MS epidemiology and has participated in clinical trials for MS therapeutics. You can follow him on twitter @Brandon_Beaber where he regularly posts about MS news and research.
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Music: INNER GRACE - Copyright 2018 Wilton Vought Source: Really Really Free Music Link: kzbin.info/www/bejne/raqcd39nYs-oppY T
he video material by Dr. Brandon Beaber is general educational material on health conditions and is not intended to be used by viewers to diagnose or treat any individual's medical condition. Specifically, this material is not a substitute for individualized diagnostic and treatment advice by a qualified medical/health practitioner, licensed in your jurisdiction, who has access to the relevant information available from diagnostic testing, medical interviews, and a physical examination. To the extent that Dr. Beaber endorses any lifestyle change, behavioral intervention, or supplements, the viewer should consult with a qualified healthcare professional to determine the safety and efficacy of the intervention in light of their individualized information.

[@shalinidhir5335]

Hey doctor!!! Your video was very informative. It put my wholehearted trust again on it. I am on aubagio 14mg and Thank God, i didnt have any relapse in the last two years since i was diagnosed with ms after optic neuritis and therefore i took five rounds of plasma exchange. Thanks once again for remembering my request. I will always be grateful. 🙏🙏

[@DrBrandonBeaber]

:) Thanks for giving the suggestion. I filmed this awhile ago, but I generally space out the publications so there is a video every week. Because of COVID-19, I delayed this one a little bit.

[@mr.sudbury3856]

I am on Aubagio. No MS-attack in 3 years

[@DrBrandonBeaber]

Thank you for sharing

[@martinschultz2631]

How do you do today?

[@mr.sudbury3856]

@@martinschultz2631 i am good. Haven’t had an attack since 2017. That is when I was diagnosed with MS

[@martinschultz2631]

@@mr.sudbury3856had 8 years no attack without being on a drug.

[@andrewkaldas3337]

Hi Dr. Brandon Beaber would you know approximately how long must I be on Aubagio before it's concentration in my blood is approximately the same each day? Or does it always increase by day? I understand the half-life is 19 days but does it take 8 months before I should experience it's full protection? Thank you.

[@vince7528]

I'm on Aubagio, mri stable for 1 year, even if I keep having "moving tremors" on my whole body but neurologist cannot find an answer to them

[@adrianaluciacespedes9252]

Is Avara (leflunomide) an equivalent option to Aubagio in countries where Aubagio is too expensive to buy? Is it used off-label in Neurology to treat MS?

[@DrBrandonBeaber]

I have used it off label, but I doubt it is used very commonly. I have a video discussing this exact topic: kzbin.info/www/bejne/pqOyhZebfppjgrM

[@SweetT77777]

Is it possible to have an increase in MS symptoms, or even a relapse, if you miss too many doses of Aubagio? I had gotten bad about missing doses during the COVID shutdown and I had a relapse in July affecting my medulla. I've now been out of my med for almost a week due to refill issues and my MS symptoms like fatigue and spasticity have worsened during that time. But the medication is supposed to stay in your system for months after stopping. Just trying to understand how missing so many doses can impact my health the way it has. Thank you.

[@meghnakothari174]

How can one plan for a baby while being on aubagio? Dr. Pls advise. How long would it take yo flush out of the system?

[@DrBrandonBeaber]

There is a procedure to eliminate aubagio described in section 5.3 of the product label (Procedure for Accelerated Elimination of Teriflunomide): www.accessdata.fda.gov/drugsatfda_docs/label/2014/202992s001lbl.pdf Please discuss this very sensitive topic with your own provider.

[@ldjt6184]

Can you please tell me why many people develop swollen lymph nodes on Aubagio whilst not having any outward signs of infection? Thank you.

[@DrBrandonBeaber]

I personally have not witnessed this as a side effect, but it is a known side effect. I am not sure why it occurs.

[@enajenaj6841]

Thanks for the video. I was just wondering if you had a patient taking Aubagio & they contracted Covid-19 would you recommend them to stop taking Aubagio. Is there any drug interaction with Tylenol. What is the rate of people stopping Aubagio due to side effects that you know of.

[@DrBrandonBeaber]

I can't give you medical advice here, but I most likely would advise stopping Aubagio in someone with active COVID-19 just because "rebound" disease activity with Aubagio is not common, so the risk with MS would be very low. Aubagio is likely lower risk than many other MS disease modifying therapies in terms of risk of COVID-19, but to me it makes sense to avoid any treatment with the potential to alter the immune system in the setting of an active and potentially severe infection. You can check webmd.com for drug interactions or talk to your provider: www.webmd.com/interaction-checker/default.htm I'm somewhat uncomfortable answering that type of question here. In the TEMSO study (Randomized Trial of Oral Teriflunomide for Relapsing Multiple Sclerosis) over 2 years, about 26% did not complete the trial who were in the Aubagio 14 mg group, most stopping because they dropped out of the study. Out of 358 people, 38 had adverse events, 17 had perceived lack of efficacy, 2 had disease progression, 5 had study protocol violations, 2 were lost to follow up, 26 withdrew consent, and 5 had other reasons: www.nejm.org/doi/full/10.1056/NEJMoa1014656

[@enajenaj6841]

Thanks for taking the time to do this video it is greatly appreciated.

[@junior10199]

Why not use glatiramir acetate as an adjunct to other DMTs given that it is relatively innocuous? I understand that a study that showed polypharmacy is not especially efficacious in MS but when was the study and what combinations of medications were tested? Given that the medications work through various mechanisms, I just don’t understand why this wouldn’t work in at least some combinations. GL and interferons? GL with and oral med? Or even non-GL combinations. Is cost the issue?

[@DrBrandonBeaber]

In the CombiRx trial, adding glatiramer to avonex revealed no additional benefit of combining the two agents (relative to just glatiramer alone): n.neurology.org/content/78/1_Supplement/PL02.003 I think we would have to have some real evidence in order to recommend combination therapy given the potential side effects. Also, why not just use a higher-efficacy agent instead?

[@-m7k0z7-9]

Can there be abnormal electrical activities in the brain that are subtle (not enough to elicit a partial seizure, but enough to be above operating range so that so an individual's perception of the world isn't as usual?) + Can IIH lead to a seizure and EEG "abnormalities"?

[@DrBrandonBeaber]

Spread of epileptic electrical activity over the cortex of the brain causing symptoms would meet the definition of a seizure. Generally speaking, idiopathic intracranial hypertension would not be expected to cause seizures or EEG abnormalities.

[@roberture5903]

Would ambagio work if you wanted to discontinue tysabri?

[@DrBrandonBeaber]

Sorry. I can't give you specific medical advice here. Tysabri is generally considered to be more effective than Aubagio, though they have not been studied head-to-head.

[@roberture5903]

@@DrBrandonBeaber thankyou Brandon, my experience with tysabri hasn't been all that great so far.

[@sandra5cents]

@@roberture5903 had relapse doing this. It’s hard to get off Tysabri. I did a 2 month overlap too. I wish I never would have stopped it. Take my chances with PML. Aubagio did not work for me. Made me so nauseous, UTI’s, rash, itching, hair loss. LESIONS. Had to do the washout. Tried to to extended dose Tysabri to reduce risk. Nope. New lesions. Onto to Ocrevus and Kesimpta, I do not feel as well that’s for sure. Don’t go down on efficacy Robert. Go up. Ocrevus or Kesimpta. Hope you are well.

[@roberture5903]

@@sandra5cents Thankyou Sandra, my next step will more than likely be ocrevus.

[@cnt2495]

So if I wanted to take Aubagio, what would that mean for me, as a male, if I wanted to make a baby with my significant partner? I don't think that I would stop taking the medication for like a week and then perform intercourse, because wouldn't Aubagio still be in my system?

[@DrBrandonBeaber]

This is a potentially serious concern. I would suggest you talk to your own provider.

[@usualobject0]

I would like to know- under what circumstances would you prescribe Aubagio to a patient?

[@DrBrandonBeaber]

Someone whose clinical situation did not warrant a high-efficacy agent if aubagio would likely be the most well-tolerated or if they didn't tolerate other agents. I would try to avoid prescribing it to women of child-bearing age regardless off their use of birth control.

[@usualobject0]

@@DrBrandonBeaber Thank-you so much. I was started on Aubagio as my first DMD at 29. Im 31 now and have not had a relapse in close 2 years. My neurologist at the time- debated on whether or not to put me on Aubagio or Ocrevus- but the safety profile was what made us go with Aubagio. I have also tolerated Aubagio very well :)

[@harmcity9934]

@@usualobject0 2023 how are you doing now?

[@desiredecove5815]

#sharingiscaring.

[@desireespamers3566]

Can you gain weight

[@DrBrandonBeaber]

I wouldn't expect weight gain to be a side effect of Aubagio.

[@marisrodriguez5364]

I did the treatment with Aubagio for 7 months and I got rid of the stain that appeared on my back but I stopped it because it gave me a lot of muscle pain and I had hair loss ,now I go with Zeposia but I'm afraid of the effects 🫢

[@oykuu281]

did your hair come back