Another case of PML on Tecfidera

Maybe ProfG will comment on this when he gets near cyberspace and not doubt Biogen have circulated this information, around the neuros. But based on info on the web there has been another case of PML on somebody using tecfidera. Based on the scant information on the web.

This was a PPMSer who was severely leucopaenic. So immunosuppression can in some people cause white cells counts to go very low and as you keep taking the immunosuppressive your white cell numbers are not going to recover. If that happens you are going to be at risk from infection. This is biology and this is where induction therapy has an advantage as you are not on rug all the time and once the drug has washed out your white cells can recover if an infection comes along. 

I am aware that BG00012 and Disability Progression in Secondary Progressive Multiple Sclerosis (SPMS) (INSPIRE) is recruiting but there is no evidence that Tecfidera is useful for people with PPMS.

There has been spin that BG-12 was going to be neuroprotective, but the drug was not universally effective in atrophy measures and the question of CNS penetration has not been clarified. 

It shows us that drugs come with risk profiles and this problem may have been avoided by a risk-averse neuro,who would not prescribed off-label. 

However, there may have been gadolinium lesions in the PPMS case.

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