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Does anybody know if there is a standard protocol for switching from Tysabri to Gilenya? Anybody did the switch?

My doctor states that if I go off Tysabri the protocol for him is:

1. wait 60 days
2. on day 60 I would get 1,000 mg of IV steroids for 1 day
3. on day 90 I would start Gilenya.

The IV steroids are a precautionary measure to protect from any kind of rebound of MS while the Tysabri clears my system.

I noticed that people participating in the Gilenya trials who were previously on Tysabri had to wait 6 months. My neuro mentioned that in part they waited 6 rather than 3 months because Novartis wanted to insure that anyone who happened to get PML from month 3-5 couldn't blame it on Gilenya. 6 months protected Novartis more than 3 months.

Good luck.

Thanks so much for this information.

Did either of you do the switch?

I am considering it.

It seems to me that fingolimod has a narrower method of immunosuppression than natalizumab, plus I do not want to risk PML.

my dr is also concerned about the rebound effect and is putting me on Copaxone for almost 2 months. I will be off Tysabri for a total of 3 months as well

Good luck to all

laurie f

They have to check also if you have antibodies of the chicken pox prior starting Gilenya.

I did the switch 4 months ago and I feel great. I didn't have a relapse, even if the efficancy is lower than Tysabri (50% vs 70% for Tysabri). I was too scared of the PML risk. This one is much safer. I always have a bottle of a sanitizer with me, I'm being careful without going crazy ;)