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Joined: Oct 07, 2007 Posts: 15 Location: Southsea, UK
Posted: Thu Jan 17, 2008 4:16 pm Post subject: Shall I Stop Rebif now waiting for Tysabri?
Hello,
I saw my neuro Tuesday and he would like me to start Tysabri. I am pleased about it (although it means my MS is progressing which sucks) though it will be a bit of time til I start - have to have another MRI and a lumber puncture first.
My question is, can I stop my Rebif now? As he has said it obviously isn't working for me, I HATE it (can't stand those injections). Should I keep going with it? WHat do you guys think? He did say to keep taking it...
Is it not the case that you have to have stopped interferons (Rebif, Avonex, etc) for a specified period before taking Tysabri? Not sure what the period is, but I think the reason for it is that interferons linger in your body for a little while after you stop taking them, and it's generally a good idea for your body to be interferon-free when taking Tysabri (ie, to avoid PML).
Probably worth asking your neuro. Personally, and I'm not a doctor, I would stop Rebif if (a) it wasn't working; and (b) I was about to start Tysabri.
"Wash Out" Period: Before beginning treatment with Tysabri, patients are required to stop their current MS disease modifying treatments, as well as wait for a certain period after receiving high-dose Solu-Medrol. While the specific amount of time required to wait is determined by individual neurologists, the following rough guidelines are applied: CRAB drugs – wait 2 weeks after last dose; Solu-Medrol – wait one month after last dose; chemotherapy-based treatment – waiting time varies according to dosage, but wait at least 3 months and up to one year.
Obviously you can quit Rebif anytime you want but it sounds like you have a cooperative neuro who told you to stay on Rebif in the meantime. I'm not sure quitting Rebif early is worth the chance of upsetting him.
Bob _________________ Wife diagnosed with MS in Feb. 2006 and is a participant in the Tovaxin IIb clinical trial.
Based on the study abstract from Pubmed below, I say if you hate it, stop right now!
MRI and clinical activity in MS patients after terminating treatment with interferon beta-1b.
Mult Scler. 2000 Apr;6(2):86-90.
Richert ND, Zierak MC, Bash CN, Lewis BK, McFarland HF, Frank JA.
Laboratory of Diagnostic Radiology Research, Clinical Center, NIH, Bethesda, Maryland, MD 20892, USA.
Monthly MRI activity and clinical disability were evaluated in two relapsing-remitting multiple sclerosis (RRMS) patients for 4 years during a cross-over treatment trial with IFNbeta-1b, and for a mean of 21 months after terminating treatment with IFNbeta-1b. Post-treatment MRI activity was compared to baseline activity in these patients. Although contrast enhancing lesions (CEL) and the bulk white matter lesion load (BWMLL) on T2-weighted images eventually returned to baseline values, there was a refractory period of 6 - 10 months after terminating treatment, before baseline MRI activity was restored. Although the mechanism for a sustained effect of IFNbeta-1b is unclear at this time, these results have important implications for enrollment of such patients into new treatment protocols that rely on contrast enhancing lesion frequency as an outcome measure.
Joined: Oct 07, 2007 Posts: 15 Location: Southsea, UK
Posted: Mon Jan 21, 2008 3:10 pm Post subject:
Thanks for your messages. I know I will get to stop Rebif before I start Tysabri, but where I have to have a MRI and lumber puncture first it will probbably be a few months. I wanna stop Rebif now!! Trouble is, the neuro said to keep going, also my ms nurse and family are the same...I guess I'll have to keep going with it, I do hate it though!! Thanks again, Laura xx
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