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MS Decisions - drug comparison results

Gilenya (England) Tysabri
Chemical name
Fingolimod Natalizumab
When was the drug introduced to the NHS?
2012 2007
How do I take the drug? information
  • Self-injectionInto muscle or under the skin. Auto-injector devices are available and full training given
  • PillMay be tablet or capsule
  • Intravenous infusion (drip) in hospitalGenerally in outpatient clinic but some DMDs require a hospital stay

Pill

Intravenous infusion (drip) in hospital

How often do I need to take the drug? information
  • DailyOnce or twice a day
  • Several times a weekEvery other day or three times a week
  • WeeklyOnce a week
  • FortnightlyOnce every two weeks
  • MonthlyOnce a month
  • Annually Treatment course

Once daily

Monthly

What type of MS is the drug for? information
  • Clinically isolated syndromeFirst episode of neurological symptoms
  • Active relapsing remitting MSTwo relapses in the previous two years
  • Very active relapsing remitting MSTwo or more relapses in the previous year and signs of MS activity on MRI scans (rapidly evolving severe)

Very active relapsing remitting MS

Very active relapsing remitting MS

How effective is the drug at reducing relapses? information

Categories recommended by ABN Guideline:

  • Moderately effective (category 1.1)Reduces relapses by about one third (30%)
  • More effective (category 1.2)Reduces relapses by about one half (50%)
  • Highly effective (category 2.0)Reduces relapses by about two thirds (70%)

More effective (category 1.2)

Highly effective (category 2.0)

Side effects information
  • Common side effects affecting more than 1 person in 100.
  • For full details see individual drug entries.
  • Cough
  • Headache
  • Back pain
  • Diarrhoea
  • Increased risk of infection
  • Decrease in white blood cells
  • Increased levels of liver enzymes
  • Basal cell carcinoma
  • Headache
  • Dizziness
  • Urticaria (skin rash)
  • Increased risk of infection
Less common but serious side effects information
  • Less common side effects affecting fewer than 1 person in 100.
  • For full details see individual drug entries.
  • Swelling in the back of eye (macular oedema)
  • Increased risk of serious infection
  • Brain infection (PML)
  • Brain infection (PML)
How often do I need to visit a clinic for regular monitoring and tests? information
  • Check-ups are important to make sure you are doing well on a DMD and to spot early signs of side effects.
  • Some DMDs require more frequent check-ups than others.

Before starting treatment, every 3 months for first year, then less frequently

Before starting treatment, every 3 months for first year, then less frequently

Conception and pregnancy information
  • You must not become pregnant during treatment
  • Treatment must not be started if you are pregnant or planning to become pregnant in the near future.
  • Pregnancy is not recommended during treatment
  • Your MS team may recommend you stop taking a DMD when trying to become pregnant and during pregnancy.
  • If you have a high risk of relapse, your MS team may recommend remaining on treatment.

You must not become pregnant during treatment

Pregnancy is not recommended during treatment

Additional information
  • In England, approved for people who relapse after taking one of the beta interferon drugs, Copaxone or Tecfidera or for people taking Tysabri who are at high risk of PML
  • Capsule contains beef gelatin
  • Cases of brain infection (PML) have been reported

 

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