Is Tysabri the right drug for my 19 year old daughter just diagnosed with MS?

Here is My Question:
My daughter is 19 and just been diagnosed with MS. Her doctor wants her to treat her with Tysabri. She has minor symptoms at the minute but has numerous brain lesions. I know this treatment is normally a second line treatment. Do you think this is the right treatment for her?

Answer:
Tysabri has been used as a first line treatment in appropriate cases of MS for many years. The definition of "appropriate" varies among MS experts but usually involves the following criteria:

1. The person must be JC virus antibody negative (or at least low titer positive, also call low index): the cut off for a low JCV index is not at all written in stone. Some MS specialists feel comfortable with an index less than 1.5 whereas others consider an index less than 1.0 or less than 0.6 as low.
   
2. The person must not have a history of prior immunosuppression such as chemotherapy
   
3. The person must have active relapsing MS
   
4. The person must be considered at higher risk for disease activity and future disability. This can be very tricky to determine in someone young, like your 19 year old daughter, but certainly a high MRI lesion burden or lesion count is one of the potential risk factors we use to make this determination.

Hope this helps

​Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego