Ocrelizumab versus Rituximab (Rituxan)

Ocrelizumab versus Rituximab (Rituxan)

I decided to go a little honest about our pharmaceutical world of MS. There has been so much press and promise over this new drug coming out for multiple sclerosis. Put Ocrelizumab in your web search and you’ll get article after article about the promise of this new drug.

NEWS FLASH!!!!

Rituximab is Ocrelizumab

The patent on Rituximab expired in the US in 2015. Basically when they were doing the clinical trials with multiple sclerosis by the time they were up to phase III the patent would have expired.

No patent=no profit.

So Genetech started inventing a new drug. The biggest difference is that Rituximab is a chimeric antibody, a genetically engineered antibody. Ocrelizumab is a humanized antibody, antibodies from non-human species, whose protein sequences have been modified to be similar to those found naturally in humans. Otherwise Ocrelizumab is basically the child to Rituximab. Being that Ocrelizumab is humanized antibody, the hope was improved safety and reduced  infusion reactions. What actually happened is it turned out that Ocrelizumab was LESS safe. In 2010 trials on Ocrelizumab for Lupus and Rheumatoid Arthritis had to be abandoned because of an unacceptable number of serious and sometimes fatal infections. Ocrelizumab is almost identical to that of Rituximab (except for the way the antibodies are created, chimeric versus humanized) which has been used for decades to treat cancers of the blood and for 7-8 years off label basis for treating multiple sclerosis. Rituximab is pretty safe, a good drug therapy, and has a large data history and experience.  It isn’t cleared for multiple sclerosis use because of pharmaceutical profit lines not seeing it to the phase III clinical trial. Therefore some insurance  companies will DENY the use of the safer Rituximab but approve the still to see Ocrelizumab when it actually is released. THEY ARE BASICALLY THE SAME DRUG. However FDA can’t  approve Rituximab for multiple sclerosis without  phase III. No phase III because of $$$$$$$$$$. We the patients are left with the choice what do we do, what can we do?

I was denied by my insurance for Rituximab and denied 2 appeals and even took the appeal to the state level and was denied (I have state insurance). I finally got into the patient assistance program from Genetech and am able to receive Rituximab (pays to be poor). However this was also because Ocrelizumab was not out yet. It was supposed to be released January 2017 but was once again push back.  There is a very good possible I may have to go to the Ocrelizumab which my insurance would pick up, because it was FDA approved for multiple sclerosis, but if prefer to stay with Rituximab.  I’d rather be on a drug that there is a well known history on, not one pulled from the shelf many times. Anyway just wanted the truth out there, I’m tired of seeing these promised articles everywhere when this drug really isn’t “NEW”.

19 thoughts on “Ocrelizumab versus Rituximab (Rituxan)

  1. United Health Care denied my infusion. They approved the first one back in August of 2016, but denied this past one in Feb of 2017. Its frustrating. I do all the right things (eat clean, workout 4-5 times a week – lifting, don’t smoke and keep alcohol to a minimum) and can’t get the treatment I need.

    1. Got denied covered now through the patient assistance program to get Rituxan and now emblem health denied infusion. Even though they aren’t paying for medicine they denied that Rituxan isn’t medically necessary. Blogged on that BS too. So frustrating

  2. I have been on Rituxan for almost 3 years, also moved/moving from RR to SP MS. My Dr. and I both agree that it is helping, progression seems to have slowed. Even without a cure, I guess one way to attack the problem is to kill the attackers which makes sense to me.

    My insurer is Kaiser SoCal and Rituxan is approved for off label use for MS. My Dr. says its the same thing as Ocre. and knows the Drug co. game and that Rituxan has a safe history. Maybe it will also help fend off skin cancer since I am one of those old souls who had a lot of sun exposure before sunscreen was even invented!

    Good Luck and keep fighting!

    1. i have been on rituxan since last year still waiting on miraculus but my insurance is paying for it i had a couple pf weeks i thought things were starting to get better then ms said ha ha i fooled you but all in all i am satisfied with treatment just wondering if insurance will make me go to the fda approved drug but i hope i can stay on what i am on

      1. I haven’t had any miracles with Rituxan but I’d prefer to stay on it as well but since my insurance was being difficult I decided to take the other road with Ocrelizumab. We’ll see as the story goes. I can’t lie, I do have my concerns.
        I really don’t think you’ll have any problems staying on Rituxan if insurance already covers it.

  3. I had to have 6 Rituximab infusions every 2 months over the course of a year as part of my post HSCT treatment and I found the cost to be amazingly high as Australian Medicare wouldn’t cover it because it wasn’t recognised as an ‘ approved’ treatment for MS in this country ! Now I know what the real story was . Anyway I did end up having the Rituximab at great expense to myself and my treatment is now complete , my walking and balance have returned to me , I now have only 2 lesions compared to the 12 I had prior to HSCT and Rituximab and my EDSS has gone from 4.0-4.5 pre-HSCT in 2015 to 1.0-1.5 post HSCT 2017 😬 Thank you for this well written and informative article .

    1. In the US they are dumb sometimes. Rituxan wasn’t approved by my insurance which cost roughly $32,000 a year because it is technically NOT approved for MS but they’ll approve the Ocrelizumab for $65,000 a year that was approved. The same basic drug. Then the question of higher health care prices falls to the patients. Not a very fair system.
      So great it worked well for you. That’s what it’s supposed to do. Hope you continue to feel better.

  4. I just came off Tecfidera after 3 years and lymphocytes count going down to 1.2. I have been off Tecfier for 90 days, I would like to go on Ocrelizamab, but after reading
    Several articles, it seems retuximab could be safer. I have also been Diagnosed with Myasthenia Gravis and had an excaserbation in 2013. Plus my arthritis is quite painful everyday. I know Rituximab would address all 3 problems, will Ocrelizamab do the same? I can get Rituximab at the VA hospital and Ocrelizamab through my private insurance. Any advice would be appreciated

    1. I can tell you rituxan has been around for over 15 years and has a lot more statistical data which I think makes it safer. As far as working for all three, I don’t know I’m certainly not a doctor. I can only say what has worked for me with my ms. I’d stay on rituxan IF my insurance approved it that’s the ONLY reason I’m changing to Ocrelizamab. I hope it helps.

  5. I have advanced MS, that is a type that doesn’t fit into one of the named types. After being stable with NEDA for 6 years, I had an exacerbation that began in October 2016 and is still ongoing. I am scheduled to get Rituxan next week and then again in two weeks. My insurance company initially denied the Rituxan because it is not FDA approved for the treatment of MS, but then approved it after a Peer to Peer review. I have had a hard time getting an estimate of the cost, though.

    1. Ritual costs roughly $9,088 per treatment. Even at the peer to peer review I was denied. I got it through the patient assistance grant. I blogged about why I need to go to Ocrelizumab http://www.multipleexperiences.org/2017/03/30/7-reasons-why-i-decided-to-put-ocrelizumab-ocrevus-back-on-the-table/ but I liked the safety and history of safety of Rituxan. However I have still progressed on the secondary side with it, unfortunately so I won’t make any false representation. I hope you find something that helps. Other than being a long infusion, I had no side effects

  6. Just some follow up on the history of the original post. Should read these 2 articles if you haven’t. I would even print out and share with my Dr./insurance provider if I was denied coverage.

    The shameful story of Rituximab in Multiple Sclerosis https://neuroimmunology.wordpress.com/2011/03/27/the-shameful-story-of-rituximab-in-multiple-sclerosis/

    Rituximab vs Ocrelizumab in multiple sclerosis
    https://neuroimmunology.wordpress.com/2011/11/03/rituximab-vs-ocrelizumab-in-multiple-sclerosis/

    1. Thanks where we wish we could do more, this went up to the state level and they still denied. We can’t fight after that, out of appeals. Some go through I just got unlucky with the doctors on the appeal board. I will check them out though.

Leave a Reply

Your email address will not be published. Required fields are marked *

%d bloggers like this: