I Switched From Ocrevus to Mavenclad. Here’s How It’s Going So Far

Almost a month ago, I did something pretty significant when it comes to my multiple sclerosis treatment.

I started Mavenclad.

After years of treating my MS with Ocrevus, my neurologist and I decided it was time to try something different. I took my first round of Mavenclad pills almost a month ago, and I'm getting ready to start my second round.

And once I finish those pills, I'll be done with my MS treatment for the year.

Not done with Mavenclad completely. I'll go through the same process again next year — one treatment week, another treatment week about a month later and then I'm done again.

But after that?

The hope is that I'm done for good.

No more infusions every six months. No daily pills. Potentially no more disease-modifying therapy at all.

As someone who has been treating MS for years, that's both incredibly exciting and a little terrifying.

So, What Exactly Is Mavenclad?

Mavenclad is the brand name for cladribine, which has an interesting history. Cladribine has also been used as a chemotherapy drug to treat certain types of leukemia.

Obviously, the word chemotherapy gets your attention.

The dose and way cladribine is used for MS is different from how it's used to treat cancer. For MS, Mavenclad targets certain B and T lymphocytes involved in the immune system's attack on the central nervous system.

It reduces those cells and then, over time, they repopulate with healthy cells.

The simplified way I think about it is that Mavenclad knocks down certain parts of my immune system that are causing problems, then gives them a chance to rebuild.

And unlike most of the MS treatments I was familiar with, you aren't constantly taking medication or going in for routine infusions.

How Mavenclad Treatment Works

This was one of the strangest things for me to wrap my head around when I first started looking into Mavenclad.

The entire treatment happens over two years, but you only take the medication during four short treatment periods.

Year one: I take Mavenclad for several days during the first month. About a month later, I take it for several days again.

Then I'm done for the year.

Year two: I do the same thing. One treatment week during the first month and another treatment week about a month later.

Then I'm done with the standard two-year Mavenclad treatment.

That's it.

Compared to years of Ocrevus infusions every six months, it almost doesn't feel like enough.

And that's simultaneously one of the things that attracted me to Mavenclad and one of the things that makes me nervous.

What Do You Mean I'm Just...Done?

This is the part my brain is still struggling with.

I've already completed my first treatment week. I'm about to start the second. Then I won't take another DMT for the rest of this treatment year.

Next year I'll do two more treatment weeks.

And after that, if everything works the way we hope it does, I may not need another DMT.

Possibly ever.

That's pretty incredible to think about. It's also nerve-racking.

There's something reassuring about actively treating a disease. With Ocrevus, there was always another infusion coming. I'd get one, six months would go by and then I'd do it again.

It became part of having MS, of life.

Mavenclad asks me to think about treatment completely differently.

Take the pills.

Let the medication do what it's supposed to do.

Monitor my MS.

And wait.

Of course, I'll still have bloodwork, MRIs and appointments with my neurologist. I'm not taking four short courses of pills and declaring myself cured. That's not what this is.

But if Mavenclad works the way we want it to, I could finish next year's treatment and potentially go years without needing another DMT.

Maybe I'll never need another one.

After years of planning my life around the next treatment, that's hard to even imagine.

Then There's the $30,000 Box of Pills

Before I could worry about actually taking Mavenclad, though, I had to get it.

And that meant dealing with one of everyone's favorite parts of American healthcare:

Insurance.

Mavenclad is expensive.

We're talking about a little box containing a handful of pills that costs somewhere around $30,000.

Thirty thousand dollars.

For a box of pills. (That's just for one week by the way)

There's something surreal about having that delivered to your house. You open the package and you're holding this tiny box that's supposedly worth more than most cars I've owned.

And because it's so expensive, getting everything approved and coordinated through insurance was frustrating to say the least.

There were phone calls. There was waiting. There were questions about approvals. There was all the usual insurance nonsense that anyone with a chronic illness is probably way too familiar with.

Eventually, everything got worked out and the medication arrived. Although I am still waiting for the approval of my second course of pills for this first year... Which I'm supposed to start in about a week.

My First Week on Mavenclad

This was the part I was really nervous about.

I'd read about the possible side effects. I'd talked with my neurologist. I understood what the medication was supposed to do.

But eventually you reach the point where you've done all the research you can do.

You just have to take the pill.

So I did.

Then I took the next dose.

And I kept waiting for something to happen.

Thankfully, nothing did.

I made it through my entire first treatment week without any noticeable adverse effects.

I didn't feel sick. I didn't have some dramatic reaction. I didn't suddenly feel completely wiped out.

I took the pills and went about my week.

That was it.

And now, almost a month later, I'm getting ready to do it again.

One More Week and I'm Done for the Year

My second treatment week is coming up.

I'm still a little nervous. Just because the first round went smoothly doesn't guarantee the second one will be exactly the same.

But having that first round behind me definitely makes me feel better going into this one.

And once I finish?

I'm done for year one.

That's still weird to say.

Next year, I'll have two more treatment weeks spread across two months. After that, I'll have completed the standard Mavenclad treatment.

Four short treatment periods over two years.

Then we see what happens.

I'll still have MS. I'll still see my neurologist. I'll still get MRIs and bloodwork. None of that magically disappears. Or maybe it does... I haven't gotten that far yet.

But hopefully, the constant cycle of MS treatments does.

That's what makes this whole thing so exciting to me.

I've spent years knowing another Ocrevus infusion was always waiting six months down the road. Now there's at least the possibility that sometime next year, I'll take my last Mavenclad pill and won't have another DMT waiting for me.

Maybe for years.

Maybe ever.

I'm not there yet.

I've still got another treatment week coming up and then two more next year.

But the first one is officially behind me.

Three to go.

And so far, so good.