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Here is My Question:
Trying to decide on new medicine to take. Right now I believe I have narrowed it down to Tecfidera or Tysabri.
My JCV came back as 0.23 positive. I am told that is considered on the low side. I used to take Avonex for about 3-4 years, but stopped about 18 months ago.
My history is this:
I have had about 2 relapses in 9 years since the original 'pain' after knee surgery in 2005 - pain on right side of face/head, left leg, some other 'minor' things possibly.
I understand Tecfidera to be about 50% effective, and Tysabri to be 98% effective. My concern is how long you can you be on Tysabri? I looked at Dr. Kinkle's flowchart (SEE FLOWCHART), and it looks like people on Tysabri for 4+ years have much greater risk of developing PML. It was my understanding that a lot of people in my position, early diagnoses with good mobility etc., are starting to take Tysabri where as a few years ago it wasn't considered unless it was an extreme case. I am confused as to how to go about my decision on which is best for me in my current situation?
You are asking the correct questions and beginning to think through this decision rationally, so let me give you a little help. While I still do not have enough information to provide the individual advice you are looking for, I can help refine the answers to some of the points you raise:
I hope this helps.
-Rip Kinkel, MD
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