I have been on Tysabri for 1 year and my most recent JCV test came back stratified at 1.29. My research indicates that this is still in a low risk range if you have not been on an immunosuppressant drug prior to taking Tysabri. I was on Copaxone for 8 years before starting Tysabri. My question is this...is Copaxone considered an immunosuppressant drug? And if it is, would it be possible for me to change to the 6-8 week regimen to be less at risk of PML but still receive the benefits of Tysabri?
These are excellent questions. Copaxone is not considered an immunosuppressant and there is no evidence that prior treatment with Copaxone increases the risk of PML on Tysabri therapy.
Your risk of PML with long term (greater than 2 years) Tysabri treatment is probably between 1 in 500 and 1 in 1000. If you’ve remained stable or even improved on Tysabri, it is very reasonable to increase the interval between infusions to every 8 weeks in an attempt to lower your risk of PML. As I have stated in prior blogs, there is mounting evidence that this strategy may be effective, even though it is not a proven strategy at this time. I usually increase the interval between infusions after 18 months of treatment.
Revere (Rip) Kinkel,
Director of the UCSD Multiple Sclerosis Center
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