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Here is My Question:
I was diagnosed officially in Oct 2013, was symptomatic and followed for 15 years prior to diagnosis. JVC positive. I started on Tecfidera Nov 2014 and stopped Oct 20, 2014 based on trend of 2014 lab values ---
dates done: 1/7, 3/21, 9/19, 10/9 and 11/11.
absolute CD3 1347 1512. 587. 418. 506
absolute CD4. 755. 929. 405 294. 337
absolute CD.8. 588. 602. 166. 121 151
absolute CD1. 74. 96. 73. 62. 92
absolute lymph 1820 1774. 785. 598. 754
% CD3, CD4 and CD8 all within normal limits but all declined and continued decline after Tecfidera was stopped.
Question is: do I restart Tecfidera or switch to Copaxone? please advise as to pros and cons. Aubagio is not an option for me.
We try to help people with MS think through the process of selecting a DMT without recommending a particular drug; this is necessary since we are provided with only a small amount of the information required to make treatment recommendations.
That being said, it is possible you pulled the trigger too early on Tecfidera; I agree that if your absolute lymphocyte count declined below 500 and remained below 500 for 3 months then it is probably time to stop Tecfidera. You could consider restarting Tecfidera and decide later based on your monthly absolute lymphocyte counts.
-Rip Kinkel MD
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