Mavenclad (Cladribine) for Multiple Sclerosis Explained by Neurologist
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- Опубліковано 4 січ 2022
- Time Stamps:
00:34 Mechanism of Action
2:12 Dose
4:32 Clinical Trial Results
5:50 Long-Term Results
7:55 Side Effects
9:23 Contraindications
9:56 Cancer
10:53 Safety/Monitoring
12:21 Drug-Drug Interactions
14:04 Miscellaneous
Mavenclad product label: www.accessdata.fda.gov/drugsa...
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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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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. - Наука та технологія
I took the first course 5 years ago and the next the following year. No relapses, no side effects at the time or following. !
Good results so far
I am a 39 years old, EDSS 0.5 RRMS patient. My NEDA is over with new lesions after 6 years and most likely I will start a new DMT. I did Rebif for 4.5 years which worked great.
Thank you very much for the video. It is very informative. Very good recap on long-term results.
I've taken it... I'm stable... thank you... and I pray I stay that way... thanks for all the info Dr Brandon...
I hope you continue to do well.
@@DrBrandonBeaber - thanks, me too...🙏🙏🙏
Thank you for the video Dr Beaber
You are one on my go to sources for MS information. Keep up the good work as us folks with MS really need and appreciate doctors like you who really help us out to navigate the complexity of this disease
Thanks. I appreciate that :)
Wow!!! Excellent information. This is fantastic info for any considering or currently taking This.
I'm glad it was helpful
I finished Course 1 a month ago. I experienced some fatigue after Cycle 1, then quite substantial fatigue after Cycle 2 but I’m gradually getting back to normal. I’m losing a bit more hair than usual, but nothing dreadful. My lymphocyte count has gone down to 0.4 and it will be interesting to see how long it takes to climb back up.
This video has been a good reminder that no DMT is a cure all, but at the same time I’m still hopeful that taking Mavenclad will bring some good!
So did you have good results?
I just finished year 1 My first dmt ever.
greetings from greece Doc. Is nice to know we have people to look after for us and giving us hope.Very good information about shingles vaccine i didnt get it cause younger i had pass chicken pox so my antibodies was high positive .
Για πές ρε αδερφέ γιατί εγώ την βγάζω με glatiramer ( ανεμβολίαστος Γαρ ), είδες κάποια ουσιώδη βελτίωση στη συμπτωματολογία σου ? Στο νοσοκομείο μου είπαν ότι 2 κύκλοι σταματάνε την εξέλιξη για τουλάχιστον μια τετραετία.
Wonderful explanation and educational video Dr Beabs- I’m on my way to second year course- but awaiting B lymphocytes to raise enough to take. Thank you for adding this med to your list of videos. ❤️Momma D & the F**kin MS Warriors.
#Sharingiscaring
#MavencladMILF
Appreciate the detailed and digestible data Dr Beaber. Researching due to minor relapse and tysabri might not be scratching the right spots. Cheers and thank you!
I'm glad it was helpful.
Thank you for this video, Dr Beaber!
You said that Prednisone is not reccomeded during the treatment with Mavenclad.
Do you mean that it's not reccomeded in the days when you receive the daily doses (5 days) , or in general during the whole time of efficacy of the drug (2 years)?
What about in the weeks in between the 2 treatment of year 1?
Thank you!
I was on Tecfidera and was constantly nauseous and loosing a lot of hair. Once I stopped the tecfidera both side effects went away. I am currently on course (year) 1, cycle (week) 2, day 3 of Mavenclad. It has been such a relief to take. It's still early to report on side effects but so far I have not had any. Headache and back pain are two of the most common that I was a bit worried about, but so far so good! I don't think I will feel comfortable going without any DMT after the 4 year Mavenclad course is complete and I would certainly be open to a 3rd course or will look at other highly effective therapies. For my lifestyle of being a medical student, this drug seemed like the best fit for me so I don't need to worry about daily pills or scheduling regular infusions. It was between this and Ocrevus when I was deciding with my neurologist what to switch to, and this just seemed more fitting at the moment.
I'm glad it is going well for you. I think most people find b-cell depleters to be convenient just because it is not a big deal if an infusion is delayed by a few months (and may actually be safer with no meaningful loss of efficacy according to some research).
@@DrBrandonBeaber I agree, I really like what the research on B-cell depleters shows and the lack of daily commitment is fabulous, especially when daily symptoms of the disease are enough, the option to avoid daily medication side effects is appealing.
@@DrBrandonBeaberkesimpta or mavenclad? I'm a man 42 yrd. Lesions spinal and brain. I can't decide...
@@KaitCervihow are you today? Your mri? OK? I'm considering taking mav or Kesimpta... I can't decide..
@@botafogofr187 mavenclad has been great so far. Had new activity at the 6 month check after my first year of mavenclad but not after 12 months. My year 2 dosing is done and I have my 6 month post year 2 MRI this week. A friend is on Kesimpta and she really likes it. Her reaction to the first few doses was bad but her Dr didn't tell her to pre-treat with antihistamine and acetaminophen and once she did that she was fine and after the first few weeks she didn't need to pre-treat at all. Both drugs have similar stats when it comes to reducing relapse rate and disability (chatGPT) summarizes this info really well if you ask it.
Starting year 2 soon! Thanks for the video
How did it go for the first year?
@@DrBrandonBeaber Great! Just some nausea while taking the pills and some extra fatigue for a month. No new lesions on MRI :)
Are there any updates on remyelination or regeneration, I have been waiting for good news on that front...
I plan to make more videos on this in the future. This is my video on clemastine: ua-cam.com/video/T6p5e2TcR9Q/v-deo.html
I Just started with my first pill yesterday. I was not keen on taking this. In fact I was and am really nervous for side effects. I took Avonex injections before and I had litterly every side effect. Also Tecfidera gave me every side effect.
Today my body hurts but I don't know if it's stres or Mavenclad. Dr. You did not say anything specifically about Zona. My doctor already prescribed me acyclovir bc I am so scared again for side effects. She told me I could start taking it after my second week.
I told myself these medication will be the last one to try bc I feel there's been so many MS medications and non was really long term proven to cure. I feel like a lab rat sometimes. But bc I don't want my family to be the victim of my illness I am willing to try even if the outcome will not be good.
I want to ask if it's OK to still take my vitamins B supplements during these first weeks of Mavenclad?
Can you talk about Lucid MS
I finished year 2 of Mavenclad in July 2020, and my MS has been stable. Treatment was easy. Unfortunately in my case, my HPV reactivated, and I developed VIN 2-3. Has the area removed, and now treating a remaining spot with Aldara. I had asked if HPV could become active again with Mavenclad, was told no. Mine sure did. With that said, I think it's a fantastic treatment, but if you have a known HPV infection, just be diligent and get checked regularly.
What is VIN 2-3?
@@kandykone88 dysplasia, precancerous cells.
were you on any other DMT afterwards? and are your MRIs still clean?
Great Video Dr. Beaber! My neurologist suggested to swith therapy from Ocrelizumab (last 6-7 years) to Cladribin, because I experienced almost 2 relapses in the last 5 years. What is your opinion on this? I have had MS for 16 yers now with EDSS of.6.0 (stable in the last 4 years).
I can't give you personal advice here. I wish you good luck.
I have ms and my neurologue had prescribed mavenclad to me i have 50kg so i think i will take 5 tablet the first cycle please doc does this drug help me to recover my lost movement and fatigue in my left leg for years before i got the foot drop just after a little effort like walking my leg drop can i regain my strenght
Thanks for the information. Although we do not currently combine MS therapies, do you believe it might be possible to safely approach (more targeted) a similar level of protection as HSCT by combining B cell depleters with drugs crossing the blood brain barrier attacking microglia (smoldering MS)? Future video Biomarkers in MS especially for monitoring DMT effectiveness.
I think combination therapy may become more common over time, but most likely, we would combine an immunosuppressant with a novel drug which prevents neurodegeneration or has remyelinating properties. I think using a b-cell depleter and a bruton's tyrosine kinase inhibitor together may not be very helpful (BTK inhibitors likely work by altering b-cell signaling). I do have one video on neurofilament light chain: ua-cam.com/video/5WaMZ36v6mA/v-deo.html
One potential biomarker while waiting for neurofilament to become available is using visual evoked potentials(eeg)
@@DrBrandonBeaber are there any new drugs coming down the pipeline for re myelination or neurodegeneration?
Hi Dr. Beaber would you do a video on why you became a MS neurologist?
Damian Washington actually asked me this exact question in an interview we did yesterday, and he should post this on his channel shortly.
Should we eat before eating Mavenclad? Any idea help plz
I have a question,
I finished first year of cladribine 3 months ago. I'm 30 years old , I've had MS for 5 years. Is it true that my period might stop forever ?
Please answe me doctor !
I am so glad this video was posted. I am currently in the process of getting approval from my insurance company so I can start taking mavenclad. This video was very helpful. But why do all MS medications cause herpes virus?
A lot of people carry the Herpes virus. When you take a therapy that suppresses your immune system, this can cause a dormant virus to reactivate. Thus people who may have never been symptomatic with Herpes may have been carrying it unknowingly, only to have it reactivate and become symptomatic on an immunosuppressive therapy. If you are negative for the Herpes virus (which can be checked in blood work), you won't develop Herpes from the medicine, nor have Herpes symptoms if you don't have the virus.
Good luck with Mavenclad, it is a great therapy!
I've been having the same symptoms as optic neuritis (I had optic neuritis in the same eye before)
The fogy vision lasts for about 2 hours and that happens 3 or 4 times a day
Could that be a relapse?
And can I have a relapse in the same place twice?
It is possible to have a relapse with the same symptoms twice, but by definition, a relapse lasts at minimum 24 hours (inflammation is a slow process). Many people can have "pseudoexacerbations" (recrudescence of prior symptoms). I can't comment on your specific situation.
But what cause pseudo relapses without any reason to have it (No high temperature, or stress, or inflammations)
And thanks a lot for this great page keep going ❤
@@maherm6707 Sometimes there is no known cause.
Some or complete remyelination of all lesions and no side effects of note. I think it would have been better to go with alemtuzumab though, better to risk thyroid complications than MS progression. Also would like to add that techniques to increase stem cell repopulation in the bone marrow such as fasting, exercising and fasting mimetic drugs are a good complimentary therapy for rebuilding the b cell count.
i'm late, but here goes: my neuro is suggesting to switch from tecfidera to a higher efficacy dmd. what do you mean with "remyelination"? did you notice symptoms improving? my only real MS symptom i notice is my leg getting fatigued quickly when i'm out for a jog/run. i cant lift my foot/leg anymore after a while. if there is a chance of this improving i might consider it...
@@murfad i had some lesions shrink or disappear off my mri - not necessarily remyelinated though. Doing a Visually Evoked Potential test helps with detecting remyelination and cheaper than a MRI. Yes I had a remission and gained way more energy now, it's been 2 years since first taking cladribine, I've also been fasting/exercising/neurofeedback/supplements/psychedelics and sleep with a pescetarian diet to back it up. I even take EBV anti-virals (just in case) but I also unfortunately have feet issues now, I'm going to take the approach of using it or losing it.
@@pelletey thanks for your reply! all the best to you
🇧🇷🇧🇷 queda do cabelho
OCREVUS is better or these tablets swap
.
Oh dear.
I really don’t want to go on a drug like this. 😟
Progression is far scarier.
remyelination. tell me when will it come out
Estimated after how many years remyelination is found?
Hi Dr!
My neurologist said it was okay for me to take curcumin while on Mavenclad. He just pointed out that I can't take any supplements 3 hours before or 3 hours after Mavenclad. Is this true? Please let me know. I'm nervous because I did take curcumin, but not within the 3 hours before or after window. I didn't have any side effects. For the 1st month a had a slight headache, but it went away when I drank water. For the 2nd month, though, no side effects whatsoever
More I know about this drug, less I want to take it. I think I will continue with my Gilenya and its headaches. My only problem with Gilenya is the headaches and fatigue, but I heard that this medication causes fatigue too, even longer than the two weeks when it is taken. So, what is the point?
I am with you on the more I know about this drug, the less I want to take it; yet my doctor wants me on it and one of her staff members even left me a message recently asking if I had started it. Upon returning the call, I informed my doctor's staff member that no; I had not started it, and wanted to wait for my upcoming appointment to discuss lab results she had me do before making the final decision. I do not like the dosing schedule nor do I like the side effect profile.
you are on a weak medication and it may be that you're not hitting your ms hard enough that's the point your nero might have been suggesting
So boiled down it's real good in the beginning then it falls off as the years go
Basically, I am not convinced that cladribine has a strong induction effect, so return of disease activity is common many years later if people (especially younger people) don't transition to another disease modifying therapy.
What’s your take on additional dosing? There’s seems to be little published data on this other than small off label cohorts in Poland and the UK showing some Benefit.
🇹🇷🇹🇷🇹🇷
(-1) loss weight
Nice. Join us on Twitter as well: twitter.com/Brandon_Beaber/status/1478762889498411012