Will Tecfidera work for me?

Here is My Question:
I've been on Gilenya for 6 years now and it has increased my liver ALT and AST enzymes. My neurologist suggests switching to Kesimpta, which is not available in adequate quantities right now, so he suggested switching to Tecfidera. However, based on my research over the internet, I've found that Tecfidera needs 24 weeks to start working and 2 years to full effect, while stopping Gilenya can cause a severe relapse in 12 weeks in some cases. Will taking Tecfidera leave me without protection during this period of time till it starts to work?

Thank you.

Answer:
Whenever a person with relapsing MS switches from either an S1P modulator (e.g., mostly Gilenya but theoretically Zeposia and ponesimod) or Natalizumab (Tysabri) to another DMT, neurologists must be mindful of the potential for a rebound in disease activity. This tends to occur faster (8 weeks or later) with S1P modulators than with natalizumab (12 weeks or later) and overall occurs in about one third of MS patients. The Restore study suggested that IV steroids, glatiramer acetate and interferons begun after stopping Natalizumab were not effective at preventing rebound activity. However, a single infusion of anti-CD20 therapy (e.g., Rituximab or Ocrevus) after stopping either S1P modulators or Natalizumab is very effective at preventing rebound disease activity. I am not aware of data showing Tecfidera to be effective at preventing rebound in this circumstance.

Revere P (Rip) Kinkel, MDProfessor of Neurosciences
Director of the Multiple Sclerosis Program
University of California San Diego
#multiplesclerosis #MS #Gilenya #Tecfidera