This was so informative- thank you! Rebound is my biggest fear- more than PML. 38% chance of rebound. Wowzers. I can't even imagine how horrific that would be because I fall under the aggressive category where steroids didn't work at all and so much damage to me happened in less than six months. Soo soo scary 😨 THANKS DR B for the video! As frightening as this is, knowledge is power and you have probably just saved a lot of people more damage because they are aware now and may be able to prevent a rebound.
@DrBrandonBeaber2 жыл бұрын
Thanks Donna. It is always better to be informed. I always try to stress the idea of rebound with anyone who is considering starting tysabri.
@frankgradus9474 Жыл бұрын
@@DrBrandonBeaber Dear Dr. Beaber, could aHSCT soon after coming off Tysabri (due to a positive JCV test while on the drug) be an effective measure to prevent a rebound?
@klbklbklb2 жыл бұрын
Thank you for another very informative video! I know I sound like a broken record as I've mentioned this on here before., but I would never have started Tysabri if I had been given the information of the possibility of a rebound once stopped. As another commenter mentioned, rebound is also my biggest fear, more than PML. I really appreciate the information in this video about steps that can be taken to lessen the chance of that happening. That does help lower my anxiety some ;) Thanks again!
@dianemunro60682 жыл бұрын
Could you talk sometime about Mayzent in those over 55yrs with progressive MS.
@mywaterbaby12 жыл бұрын
Thank you Dr. outstanding information. Thank you very much for posting and taking your time. Greatly appreciate it. Keep up the amazing work.
@stonz422 жыл бұрын
Thanks for the info Dr. B. I recently went through the transition from Tysabri to Ocrevus after only 5 months due to the JC virus. Had I known about rebound relapses when I chose the initial treatment, I probably would have opted to start on Ocrevus. Could you post a video about how the immune system adapts to operating without b-cells? I'm curious as to how the chances of infection remain relatively low in people on b-cell depleaters in comparison to the general population. I was hesitant to begin on Ocrevus because I was under the impression that not having b-cells would pose a more significant risk for all cause infections.
@DrBrandonBeaber2 жыл бұрын
I will do a video on long-term risk with b-cell depleters at some point.
@MrKoshnica2 жыл бұрын
super informative! Thanks!
@DrBrandonBeaber2 жыл бұрын
:)
@hackett11812 жыл бұрын
Thanks for all the information, so thorough, and I wish I had this when I stopped to Saab eight years ago. Even then, when I was researching, I could see people suffered severe rebound from stopping the medication. Unfortunately, even when I brought printouts of this into my neurologist, he dismissed it. I went six months without no medication before I was put on copaxone. I was one of the lucky ones that I didn’t suffer a severe rebound.
@DrBrandonBeaber2 жыл бұрын
Years ago, a "washout" period was widely recommended unfortunately. The fear of combining tysabri with other medications was overwhelming.
@ldjt61842 жыл бұрын
These drugs are a nightmare.
@freethinkeralways2 жыл бұрын
My thoughts exactly! And all these meds r taken in hope of illusive future disability prevention.
@franceszapata9512 жыл бұрын
I'm going through that right now because of Gilenya. It's been a year and I'm still numb from the neck down😔 I am supposed to start Kesimpta in December
@Sharla12132 жыл бұрын
So sorry to hear
@acvmomma70508 ай бұрын
Was this symptom from a rebound or something else ? Also, how are you doing on kesimpta now ?
@Sharla12132 жыл бұрын
Such a double edged sword. I was having a ton of relapses before Tysabri and needed it (2008) had rebound coming off but I still think it was a net gain for my MS.
@nonameavailablerlb2 жыл бұрын
Another great video. How about a video on spinal cord atrophy. Do biologics help? What is your approach to treating patients with spinal cord atrophy?
@Robin-me8fe2 жыл бұрын
Another great video !
@DrBrandonBeaber2 жыл бұрын
Thanks Robin
@cj_19862 жыл бұрын
Great video. Are there newer studies that show post Tysabri transitions to b cell depleters or IRTs and rebound activity with no washout period? Be Interested to see if those relapses are due to the wait for new drug Luckily in Australia I don't need to wait and can switch whenever I need to
@roupakali41012 жыл бұрын
I watch all your videos. They are great thank you.
@DrBrandonBeaber2 жыл бұрын
Thanks Roupak
@bethmcgregor71442 жыл бұрын
Can you make a video on Bafairtam
@poolmotorrepairguyFL2 жыл бұрын
Jay the Florida pool pump motor repair guy. When Service Calls Longwood approved ! that was good info 2 know 👨🔧Dr. Brandon Beaber
@tvdb61532 жыл бұрын
Hi Dr. B.....would a one-time infusion of Ocrevus or Kesimpta injection within 30 days after stopping Tysabri curtail the risk of rebound due to killing off the sequestered B-Cells? I have also heard of using 1000mg Metlyprednisone monthly for two months and then 3 days of 1000mg on the third month to reduce rebound? Thoughts?
@tvdb61532 жыл бұрын
?
@hurkuy2 жыл бұрын
Another amazing, informative video about Ms and MS medication!!! Does Aubagio have rebound effect too?
@DrBrandonBeaber2 жыл бұрын
There are a few case reports of this: pubmed.ncbi.nlm.nih.gov/32120027/ However, it is very uncommon.
@hurkuy2 жыл бұрын
@@DrBrandonBeaber Thank you doctor!
@pmooremoore27982 жыл бұрын
Great info, thank you as always for taking time to educate! Video suggestion - Are there studies &/or do you have thoughts for the 60+ population with quiet RRMS or CIS who have stopped their DMT w/o issue? Risk's for infection increase in general for this population, so low wbc or lymphocytes etc as we age adds more risk. For ex, I've been on Tecfidera for 3+ years, mri's stable, but lymphocytes are ~0.6 & wbc slightly below normal range. Would love a discussion re the risks vs benefits with a mild case of ms :)
@DrBrandonBeaber2 жыл бұрын
I am going to do a video on MS controversies which will mention the 60+ question though I can't give you personal advice on the issue with low lymphocytes. Certainly low lymphocytes in people taking tecfidera has been linked with [very rare] cases of PML.
@pmooremoore27982 жыл бұрын
@@DrBrandonBeaber Thank you! I look forward to all of your videos! Such great info.
@beastywild2 жыл бұрын
Thankfully I live in Ireland and we have free healthcare so I don't have to pay for my Gilenya.
@DrBrandonBeaber2 жыл бұрын
:)
@mimiwhite1963 Жыл бұрын
I am in the US , have insurance and with the Gilenya Go program mine is fres.
@angelapuric67012 жыл бұрын
Wow, my neurology did not mention the risk of relapse after stopping Mayzent. I just started a new drug - Vumerity, straight after stopping Mayzent on 10/1/22. Anything I can do health wise to try to not have a relapse?
@matthewwulff8292 Жыл бұрын
Dr B, are there any reported cases of rebound with patients taking Zeposia?
@acvmomma70508 ай бұрын
The examples you gave of the patients who had rebound, were they on their new DMT yet or in the waiting “washout” period and hadn’t started the new drug yet ?
@hannanhan2 жыл бұрын
I did stop Gilenya because I wanted to get pregnant. I didn't have any big problems before that. I could walk 10km etc. My symptoms went really bad situtation after stopping medicine. Almost paralyzed. I did get pregnant and almost all symptoms decreased but then I had a miscarriage and all the symptoms returned. Then I got pregnant again and same thing happend with the symptoms. Now I'm really scared what will happen when I give birth, will all the symptoms return again.. Is there any studies about that?
@DrBrandonBeaber2 жыл бұрын
I have a video showing an article on this topic: kzbin.info/www/bejne/bKStf5aid69nmKM
@ninawam92 жыл бұрын
Thank you for this video, doctor i'm a neurology resident and i would like to know what's the difference between IRIS and rebond and can we have IRIS without PML ?
@DrBrandonBeaber2 жыл бұрын
IRIS in the context of MS essentially refers to a severe rebound flare, and you can definitely have IRIS without PML. When tysabri is stopped due to active PML, it is common to have unusual PML lesions with active enhancement and edematous lesions.
@ninawam92 жыл бұрын
@@DrBrandonBeaber thank you 💙
@frankgradus9474 Жыл бұрын
A good question.
@Mastercreek9 ай бұрын
Went off Tysabri started mavenclad. Severe nerve pain and worsening symptoms. I feel like I'm dying
@Sharla12138 ай бұрын
If you’re still suffering, I would ask your neurologist about steroids to calm things down. that’s what they gave me after I stopped Tysabri
@Mastercreek8 ай бұрын
@@Sharla1213 I'm intolerant to steroids. Had adrenal insufficiency the last time I went on steroids so thats not an option. Thankfully I'm feeling better
@lanadel35899 ай бұрын
i was using fingya i never had attack while using it then i stopped using it because of the Side effect and i had an attack my doctor said we should start new medicine its ocrevus but im really scared and i dont know what to do is it a real reason to start ocrevus?
@ernietollar4072 жыл бұрын
If one is diagnosed past 55 years of age with PPMS, and factors in life expectancy, and not super fast progression.. there may be a fair argument against DMT altogether? THough I imagine the 'rebound' factor more so hitting younger patients would be a fair counter argument.
@yucelkrc442 жыл бұрын
First of all, thank you for your hard work. My wife switched to cladribine because she had frequent attacks in gilenya. Cladribine was started after a period of 1 month due to the risk of rebound. but despite starting cladribine early, she experienced 3 attacks in 6 months. Can the rebound effect last that long? He's currently 6 months on his 2nd year dose of cladribine, and will take a monthly dose of cortisone for the remaining 6 months. Although we started cladribine early, why didn't it start to show its effect? And do you think it makes sense to wait for the 2nd year dose of cladribine or switch directly to ocrevus? I would be very grateful if you could reply my dear doctor. lots of love
@roupakali41012 жыл бұрын
If you have stopped Tysabri 5 years ago and had a severe rebound what drug should be used in order to go back to the condition before stopping Tysabri. I am writing on behalf of my son who has MS and we live in London, UK. With my best regards.
@DrBrandonBeaber2 жыл бұрын
I'm sorry, but I can't give you personal advise here. Often, people with more aggressive disease are advised to use higher efficacy medications (Tysabri, ocrevus, rituximab, kesimpta, cladribine, Lemtrada, etc)
@roupakali41012 жыл бұрын
@@DrBrandonBeaber thank you dr
@dademyst4472 жыл бұрын
Avonex doesn't have rebond effect after stopping it right?
@DrBrandonBeaber2 жыл бұрын
Generally speaking, it doesn't
@dademyst4472 жыл бұрын
@@DrBrandonBeaber Grazie doctor!
@shawn75172 жыл бұрын
Hi Dr do you find some people with type 2 diabetes that are on tecfidera that tecfidera rises the sugar levels. As I just started tecfidera 2 days ago and is finding my sugar levels have been high is this something common in some people?
@DrBrandonBeaber2 жыл бұрын
I have not personally seen this with tecfidera.
@shawn75172 жыл бұрын
@@DrBrandonBeaber thanks for reply you do a amazing job your videos are so helpful and great
@desiredecove58152 жыл бұрын
#Sharingiscaring
@samlatooni2 жыл бұрын
Dear Dr Bieber, I got diagnosed with the relapsing remitting ms in August 2022. I was firstly recommended tecfidera at a hospital here in Frankfurt germany.but when I went to a neurologist, he recommended kesimpta...I am confused,could you please compare these two therapies???... I am 41 , male, single and with no immediate family. I am really afraid of being disabled.... Please help me decide. Thnx