Madam, - The reports in your edition of August 2nd regarding natalizumab (Tysabri) therapy and PML (progressive multifocal leucoencephalopathy) may disturb some people with multiple sclerosis (MS) who are receiving this drug.
Firstly, one must accept that any such drug has potential risks; it is used only for people with very active MS for whom other available therapies have failed and who need more effective treatment. Patients who go on treatment with Tysabri are fully informed about potential side-effects. Before each infusion they are checked by a doctor on the neurology team or a specialist MS nurse to assess their progress in the four weeks since their last infusion.
Patients are specifically asked to report any new or unusual symptoms; if there are any, they are assessed by a consultant neurologist before treatment continues. MRI scans are arranged urgently if there is any concern, but MR imaging is not performed routinely every six months, in keeping with best international practice.
It was reported that treatment with Tysabri carries a risk of pneumonia and tuberculosis; this is not the case; such risks may be seen in anti-TNF therapy for rheumatoid arthritis. Finally, when neurologists begin treatment with Tysabri, they are supported by a team of specialised nursing staff who are fully informed about the use of this drug - a very important part of the range of therapies for this disabling condition.
It is hoped that additional MS specialist nursing staff will be appointed in the immediate future to various neurology centres around the country, and that further appropriate infusion centres will be made available on-site to further facilitate safe administration and monitoring of natalizumab in Ireland. - Yours, etc,
MICHAEL HUTCHINSON,
NIALL TUBRIDY,
Consultant Neurologists,
St Vincent's University Hospital,
Dublin 4;
RAYMOND MURPHY,
DOMINICK McCABE,
Consultant Neurologists,
Adelaide and Meath Hospital,
Tallaght,
Dublin 24;
PETER J. KELLY,
Consultant Neurologist,
Mater University Hospital,
Dublin 7;
AISLING RYAN,
BRIAN SWEENEY,
Consultant Neurologists,
Cork University Hospital.