Is it OK to take Tecfidera as I move into secondary progressive MS?

Here is My Question:
Is it ok to take Tecfidera for protection as I am rapidly moving into "secondary progressive MS" and Ocrevus is not an option as I have breast cancer history! Any advice from you would be much appreciated.

Answer:
There are many options for people in the late relapsing phase of multiple sclerosis, including Tecfidera. We do not provide specific prescribing advice on this site but the following general guidance may be used to help with your decision.

1. There are no current DMTs approved for established secondary progressive MS. All current therapies are approved for 'relapsing forms' of MS, including those patients with superimposed worsening of their disease AND relapses. This is also called secondary progressive MS with relapses or early secondary progressive MS. These are all confusion designations. Distinguishing between different stages of MS is more art than science, and many experts would disagree on the designation in any individual patient. Most MS experts use a combination of age, risk factors, clinical characteristics, and medical co-morbidities to determine the most appropriate DMT or to determine if DMTs should be used at all. Almost all clinical trials restrict enrollment to those people under the age of 60 (if not 55), so little is known about the benefits or risk of treatment in people over the age of 60.
2. It is important to establish short- and long-term goals for starting a DMT: what are you trying to accomplish and what risks are you willing to take to achieve those goals? This is something to discuss with your doctor
3. Once you decide to start a therapy you need to monitor your condition regularly to make sure you are achieving your goals and not developing complications. This monitoring may include collecting functional performance measures on a regular basis and noting them for doctor in a journal, and getting regular monitoring blood tests or MRI scans, if appropriate. For instance, it is particularly important to monitor your lymphocyte count while taking Tecfidera.

Good luck

Revere (Rip) Kinkel MD
Director of the Multiple Sclerosis Program
Professor of Clinical Neurosciences
University of California San Diego