For folks who are JCV positive is Gilenya a less risky option than Rituxan in regards to the risk of PML? I am switching from Tecfidera because of low lymphocyte count.
The risk of PML is low with both Gilenya and Rituximab. However, your risk of PML is elevated because of your low lymphocyte count on Tecfidera. Make sure your lymphocyte count returns to normal before starting something like Gilenya, since Gilenya will also lower your lymphocyte count in a different way making it impossible to know if your lymphocyte count had returned to normal before you started the Gilenya.
Revere (Rip) Kinkel MD
Director of the Multiple Sclerosis Program
Professor of Clinical Neurosciences
University of California San Diego