Shall I Stop Rebif now waiting for Tysabri?

laura55 · Post by **laura55** » Thu Jan 17, 2008 2:16 pm

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...

Thanks for any answers,
Laura xx Take care xx

mjs · Post by **mjs** » Thu Jan 17, 2008 2:45 pm

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.

Lyon · Post by **Lyon** » Thu Jan 17, 2008 5:53 pm

dignan · Post by **dignan** » Thu Jan 17, 2008 6:37 pm

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.

laura55 · Post by **laura55** » Mon Jan 21, 2008 1:10 pm

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