Debate on rituximab vs. ocrelizumab (Rituxan vs. Ocrevus) in MS Journal

[agate]

I'm not sure that these articles tell anything not already covered here but just in case anyone is interested, the Multiple Sclerosis Journal has published an article in favor of Rituxan as an acceptable alternative to Ocrevus in treating MS, another article opposed, and a commentary on both articles:

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[Sunshine]

These are very interesting articles.

A nurse at my infusion center said Rituxan is more expensive than Ocrevus. But this article says the opposite.

[Cherie]

Ocrevus is nearly a third more per dose than rituxan. Made by the same company...Genentech.

[Sunshine]

Thanks. I guess the RN was misinformed

[stillstANNding]

Does it seem like Genentech wants us to take Ocrevus instead of Rituxan? If so, why?

ANN

[Cherie]

They have put a lot of effort and money into the humanized monoclonal antibody specifically for mS while Rituxan is used in other illnesses and will continue to be used there. I think (don't know for sure) that it is their way of diversifying.

[Lazarus]

These are very interesting articles.

A nurse at my infusion center said Rituxan is more expensive than Ocrevus. But this article says the opposite.

This article is correct. Don’t you remember...the patent on rituximab was running out so the company tweaked it, changed the name to Ocrevus, and kept the price high on Ocrevus. Follow the money. It always leads to the truth.

[Lazarus]

They have put a lot of effort and money into the humanized monoclonal antibody specifically for mS while Rituxan is used in other illnesses and will continue to be used there. I think (don't know for sure) that it is their way of diversifying.

Vollmer uses rituxan and Ocrevus interchangeably in his talks.

[Lazarus]

Does it seem like Genentech wants us to take Ocrevus instead of Rituxan? If so, why?

ANN

Money money money money.

[SuzE-Q]

Does it seem like Genentech wants us to take Ocrevus instead of Rituxan? If so, why?

ANN

Think the patent just ended on Rituxan, so cheaper generics will be available. And so they rebranded and marketed as Ocrevus to try and keep the cash cow coming in.

[stillstANNding]

Thank you all.
ANN

[ssusan]

Why do they do Rituxon two weeks apart. Is it a half dose like the Ocrevus first time?

[Lazarus]

Why do they do Rituxon two weeks apart. Is it a half dose like the Ocrevus first time?

What is the Ocrevus dose? Then what is the rituxan dose? Do they determine dose by the patient’s weight so that we all get different doses?
I have never heard the words about half dose applied to any of my rituxan infusions. I just know that it is the standard protocol that is used for rituxan infusions for all my friends on rituxan here or at the MS clinic where Ionete is. Good question for her!

[ssusan]

Let me try it this way, why is the protocol for Rituxon twice two weeks apart and then every six months.Ocrevus is once every six months. Everyone gets the same dose 600 mg
I think Rituxon is the same ramping up the rate

I can’t find the Rituxon doseage

[agate]

This article is from 2016 but might help:

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It was a trial but this was the dosage regimen:

Patients were usually treated with single infusions of 500 or 1,000 mg rituximab IV every 6–12 months, in some cases after an initial higher dose treatment course (1,000–2,000 mg subdivided into 2 infusions given within 1 month).

Also there is this in the article:

RITUXIMAB DOSING.The 2 most common rituximab protocols in Sweden are 500 and 1,000 mg every 6 months as single maintenance doses after an initial dose that may vary from 500 to 2,000 mg, sometimes divided into 2 infusions within 1 month. To compare these 2 treatment regimens, we subdivided the RRMS cohort into those who had received ≤750 mg/infusion and those who had received >750 mg/infusion as maintenance dose.

Sounds to me as if some people got the higher dose at first, which was subdivided into two doses within a month, but why some people got that higher dose isn't clear to me.