Transcript TYSABRI FLOWCHART

TYSABRI PATHWAY
RRMS with 2 or more disabling
relapses in one year with 1 or more
Gadolinium enhancing
lesions on brain MRI
YES
YES
Offered Tysabri in OPD
by Consultant. Overview
of risks and benefits given
RRMS with 2 or more
disabling relapses in one
Year and a significant
Increase in T2 lesion load as
Compared to a previous recent MRI
Refer to MS Nurse for
Literature and DVD
YES
YES
YES
Counselling with
Consultant/nurse
prior to final
decision
YES
RRMS with high relapse rate
whether on disease modifying
therapy or not.
YES
Clinical Investigations prior to 1st infusion:
1.
2.
3.
4.
5.
Three months washout from DMTs
MRI scan
Lumbar puncture
Full blood count
Allergies and drug history especially any
immunosuppressant
YES
NO ABNORMALITIES FOUND
AND SUITABLE FOR TYSABRI
NO
YES
For further counselling and
discussion of risks and benefits.
Discussion re: funding issues and
Offer of drug for 6 months only.
CONSENT FORM TO BE SIGNED
Including patient’s understanding
of funding issues.
YES
Administer infusion.
Monitor for hypersensitivity throughout
Infusion and for 1 hour post infusion.
Give patient Patient Alert Card
Give patient details of who to contact
If problems arise.
Apply to PCT for funding.
NOT SUITABLE FOR TYSABRI DUE TO;
•Patient is hypersensitive to Tysabri or
any of its’ carrier substances.
•Patient has PML or any other active
Malignancy.
•Patient is under 18 years old or over 65
years old.
•Patient is pregnant or breast feeding.
•Patient is immunocompromised.
YES
Consultant to discuss further
treatment options and management
strategies with patient.