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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Severe Case Of Crohn's. Take Tysabri Or Ustekinumab?

Hi, My wife who has a severe case of Crohn s and we are debating wheather to take Tysabri or Ustekinumab. She has already trie Humora and remlicade. We are leaning towards Tysabri. However one of her Gastro md s suggested that if she takes Tysabri and is ineffective she might have to wait a long time before trying Ustekinumab. However if she uses Ustekinimab there will not a need to wait to then try Tysabri. My question is what is your opinion and are there any medical studies regarding the waiting period to try another drug if Tysabri feels. Thank you, Lee Rosen
Thu, 7 Mar 2013
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Internal Medicine Specialist 's  Response
Hello,
Welcome to HCM,
Treating a severe form of Crohn's disease is challenging task for a clinician, I do understand the problems from your side.
As per the details u have given, u are going towards using Tysabri ...right?? Tysabri contains NATALIZUMAB , which is an monoclonal antibody used in the treatments of severe cases with non responding to other drugs like steroids, other immunosuppressants like azathioprine, infliximab.

But there is lot a controversies , risk Nd benefits with TYSABRI , iam giving the details as follows ,
1. Treatment with Tysabri increases the risk of dangerous CNS infections like with JC virus and herpes virus..leads to a clinical condition called PML ..progressive multifocal leukoencephalopathy and herpes encephalitis leading to even death..
2. Patients who were receiving this tysabri should be monitored carefully every 3months , to check whether they are acquiring the above CNS infections
3.prior MRI before starting surgery should be taken
4,. The chances of getting CNS infections will be doubled if the patient is already on immunosuppressive.

So I advise you to consult a specialist and discuss the risks out of benefits before using the medicine...

Hope this will help u a lot..bye
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Severe Case Of Crohn's. Take Tysabri Or Ustekinumab?

Hello, Welcome to HCM, Treating a severe form of Crohn s disease is challenging task for a clinician, I do understand the problems from your side. As per the details u have given, u are going towards using Tysabri ...right?? Tysabri contains NATALIZUMAB , which is an monoclonal antibody used in the treatments of severe cases with non responding to other drugs like steroids, other immunosuppressants like azathioprine, infliximab. But there is lot a controversies , risk Nd benefits with TYSABRI , iam giving the details as follows , 1. Treatment with Tysabri increases the risk of dangerous CNS infections like with JC virus and herpes virus..leads to a clinical condition called PML ..progressive multifocal leukoencephalopathy and herpes encephalitis leading to even death.. 2. Patients who were receiving this tysabri should be monitored carefully every 3months , to check whether they are acquiring the above CNS infections 3.prior MRI before starting surgery should be taken 4,. The chances of getting CNS infections will be doubled if the patient is already on immunosuppressive. So I advise you to consult a specialist and discuss the risks out of benefits before using the medicine... Hope this will help u a lot..bye