The number of cases of progressive multifocal leukoencephalopathy, or PML, in patients taking Biogen Idec
The latest monthly update listed 10 new cases of PML, bringing the total count to 95. The brain infection has killed 20 of the 95 patients that have been stricken while taking the multiple sclerosis drug.
As the number of patients taking Tysabri increases, we're bound to see the PML cases increase, but the update for January was considerably higher than the last two updates; November had four new cases and December had six.
Of course, one month doesn't make a trend, and Biogen points out the overall rate is still fairly low at 1.16 per 1,000 patients.
The question is where does it cross the line from being an acceptable risk to being an unacceptable one. Tysabri is the best multiple sclerosis drug out there, but there's a point at which doctors and patients won't think the benefits outweigh the risk, and they'll head to other treatments such as Teva Pharmaceutical's
The Tysabri duo could also lose sales if patients decide to go on drug holidays. The risk of getting PML increases the longer a patient is on Tysabri. Patients may try to delay increasing the risk by taking a break from treatment, cutting into Biogen and Elan's sales.
The companies can't do anything to affect the rate of PML, but they can help patients identify risk factors that increase the likelihood of getting PML. If the companies encourage patients who are least likely to get PML to take Tysabri, the overall rate should decrease.
In that vein, the companies are developing a test for the virus that causes PML. Patients who don't have the dormant virus in their systems are less likely to get PML when Tysabri deadens their immune systems.
Biogen and Elan better hurry, before the marketing message is permanently damaged.
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