The most common reason for stopping Tysabri in these circumstances is the desire to get pregnant or concern about developing PML (Progressive Multifocal Leukoencephalopathy) with continued treatment. Normally, pregnancy is partially protective in MS patents during the 2nd and 3rd trimester but there are increasing reports of patients stopping tysarbi and experiencing severe relapses even during the 2nd and 3rd trimester. These relapses coincide with the period of greatest risk for relapses after stopping Tysabri, in other words 4-8 months after the last infusion. One approach is to stop Tysabri and not attempt pregnancy until you are beyond the risk period for these more severe relapses but undergo frequent MRI and clinical monitoring by your MS specialist during this period to ensure your MS is not becoming too active to attempt pregnancy. Often we will place individuals on copaxone immediately after the last infusion of Tysabri or even before stopping Tysabri in an attempt to prevent Tysabri withdrawal relapses. The best approach and advice will depend on your individual circumstances. I would suggest discussing this with an MS specialist who has significant experience with the use of Tysabri and managing pregnancy in MS.
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