Should my son start with Tysabri or Ocrevus?

Here is My Question:
Hi my son is 17 and has recently been diagnosed with relapsing remitting MS. He is JC negative. His Neurologist has offered him the choice of Tysabri or Ocrevus. Cost is not a factor as both are covered by the PBS in Australia which means they are available at very minimal cost.

We are finding it very difficult to work out which one to start with. So far he has not had any steroid treatment. He does have a spinal lesion. What are your thoughts? Thanks

Answer:
This is a great question and one for which there is no right answer. On one hand the Tysabri is a monthly infusion while Ocrevus is twice a year. On the other hand, Ocrevus is more immunosuppressive than Tysabri. In general, for new starts in the US, more patients are starting with Tysabri than Ocrevus, but this may change over time as more data becomes available. The efficacy data for both is great, but there is more long term safety data with Tysabri. In the end, whichever one is chosen, careful monitoring is indicated to ensure an adequate response to the medication.

Benjamin M. Greenberg, MD, MHS
Vice Chair of Translational Research and Strategic Initiatives
Cain Denius Scholar of Mobility Disorders
Distinguished Teaching Professor
Department of Neurology and Neurotherapeutics
Department of Pediatrics
UT Southwestern Medical Center
Dallas, Texas