Here is My Question:
I recently tested with a JCV value of 3.76. I may be wrong but this seems to be a good reason to not start any of the immunosuppressant medications versus Copaxone. I've been having problems with the Copaxone, more psychologically than anything and my doc recently suggested we could try tecfedra. But now given this number, since it seems significantly higher than the "top range" numbers.
A side note is, is there any reason to be concerned about a number that high - at 3.76? I also had more than 6 OC bands in a spinal tap, and wonder if there is a connection there with the JCV.
I'm sure my doc will agree is not a good idea but was wondering on feedback here.
The JCV tiger level really only has significance if you are on a DMT that is associated with PML. Tecfidera certainly is one such DMT. Other considerations for choice of appropriate DMT is the topography of your disease (ie, where in the nervous system has the MS attacked). For those with involvement of the posterior fossa or spinal cord, consideration for a highly effective therapy should be considered. Unfortunately, those therapies tend to be associated with PML.
Of those, the b-cell biological appear to be lower risk. For those without involvement of the spinal cord or posterior fossa, a modestly effective therapy like glatiramer or interferon-beta could be more appropriate and are not associated with PML. Ultimately you will want to talk with your neurologist to understand why a specific DMT is being recommended and while others are not.
A. Scott Nielsen MD MMSc
Neurologist and MS Specialist at Kaiser Permanente
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