Not sure about my neuro

[skinner]

I am in the process of switching from Tysabri to Tecfidera and my neuro says I should wait 90 days after my last infusion before stating any new med.Anybody else ever do this and have the 90 day wait ?? Thanks

[Marco]

Honestly, it might take you just as long to find a new neurologist, have them review all your information and prescribe Tecfidera as it would just waiting the 90-days.
Unfortunately, there are no uniform standards for "wash out" periods when moving from one drug to another. You would think Biogen would release some standards if only moving to and from their own medications. I've had this discussion with them on a number of occasions and they've always deferred to the neurologist. The gorilla in the room is obviously PML. If you look at the Tysabri safety information, Biogen suggest you should be wary of PML symptoms for up to 6 months after stopping Tysabri.
http://www.tysabri.com/safety-with-tysabri.xml

• The one patient that developed PML after transitioning to Gilenya from Tysabri had a 6-week washout period. They had been on Tysabri for 3.5 years. I'm pretty sure the Gilenya/PML patient would love to go back in time and have a longer wash out period.
  
• There are four Fumaderm patients that developed PML. Fumaderm is closely-related to Tecfidera. All four patients had additional medical complications and probably should not have been on Fumaderm. No Tecfidera patients have contracted PML.

Did your doctor explain why the 90-day wash out period? Was this a requirement or merely a suggestion?
How long have you been on Tysabri? Is your JCV titer high?
Did you discuss Tysabri rebound?

My understanding is a new lumbar puncture and MRI can rule out asymptomatic PML and then the long washout period would not be required. You could then start Tecfidera sooner hoping to avoid the Tysabri rebound. Please keep us informed of what happens.

[skinner]

Hey Marco Thanks so much for your info--I guess I am a little afraid to switch and a little afraid not to. I will keep in touch.

[dyin_myelin]

I did a 70 day wash. It was supposed to be less than that, but the paperwork and insurance pushed it out. My neurologist is very conservative and approved this time frame. Statistically I was more worried about rebound.

[dyin_myelin]

This may put your mind at ease a bit:

http://www.wheelchairkamikaze.com/20...2-and-pml.html

[laurasari]

I had a 90 day washout. My dr said he wasn't sure so he asked a ms specialist. Good luck

[bjrnewlife2013]

I've never waited 90 days, but have for 30. I have been on 3 therapies in the last 7 years and looking for a new neuro. I'm thinking 90 days is a bit long to be without anything.