Nov 15, 2006
Perceived effectiveness for To prevent further relapses and slow the disease process down:
Not at all
300 mg/15 mL
every 4 weeks
Advice & Tips:
The emergence of progressive multifocal leukoencephalopathy (PML), a rare but deadly viral infection of the central nervous system (CNS) [is] associated with immunosuppression [NOT Tysabri], see the expert opinions from the authors of the New England Journal of Medicine: http://tinyurl.com/2mhn82.
Every MS patient that has been diagnosed with developing PML had become a severely immune suppressed either by previously treating with medications such as Azathioprine/Imuran, Methotrexate, Novantrone, Remicade, etc., all of which can last in the body for a very long time (months and months-causing the immune system to become severely suppressed/compromised), even though some of the medications listed above were previously discontinued by the patient, or they received treatments such as monthly pulse steroids, IVIG treatments (which I can also severely suppress the immune system), or whose immune system was previously modulated (changed) by treating with one of the ABCRs, causing the immune system (which is extremely fragile) to become severely immunocompromised, or whose immune system was already suppressed for whatever reason, or became severely suppressed during Tysabri therapy and their neurologist never intermittently tested their immune system to make sure it was still strong and had not dropped too low where it could not fight off any proliferation of the activated JC virus.
There is an assay called the ELISA test which is very sensitive and can be used to test the strength or weakness of a patient's immune system. If a patient is suspected of having developed PML due to activation of the JC virus, there are certain measures which can be taken to ensure the best possible outcome for the patient: 1) have additional MRIs taken and compare them with the MRIs taken prior to starting Tysabri therapy; 2) immediately stop Tysabri therapy; 3) if warranted, send a sample of the patient's CSF to Eugene Majors' lab at the NIH to have a very sensitive test for determining the presence of JC virus DNA, which can develop into PML; 4) initiate a course of plasmapheresis exchange (PLEX) to remove Tysabri completely from the patient's system. PML IS NO LONGER A DEATH SENTENCE if due diligence, awareness, and vigilance is undertaken by both the patient and their neurologist to watch for the development of any new symptoms which are indicative of PML and to act quickly.
With over 60,000 patients worldwide on Tysabri therapy (as of June 2010), the risk of developing PML remains 1 in 1000, and is still well within the ratio listed on the Tysabri label.