Mayzent vs. Tysabri for Multiple Sclerosis: Important Differences and Potential Risks.

Key takeaways

Mayzent (siponimod) and Tysabri (natalizumab) are both used to treat relapsing forms of multiple sclerosis (MS), but they have some key differences. Of note, Tysabri has an additional indication for Crohn's Disese (CD). Mayzent is taken orally as a tablet once a day, while Tysabri is given as an intravenous (IV) infusion once a month. Mayzent requires genetic testing before starting treatment to determine the appropriate dose, whereas Tysabri requires enrollment in the TOUCH Prescribing Program due to its risk of serious infections like progressive multifocal leukoencephalopathy (PML). Mayzent can cause side effects such as headache, high blood pressure, and falls, while Tysabri can lead to headaches, fatigue, and urinary tract infections. Additionally, Mayzent is not safe during pregnancy, and Tysabri's safety during pregnancy is not well established. Both are only available as brand-name medications.

Mayzent

(siponimod)

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Tysabri

(natalizumab)

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Summary for Mayzent

Prescription only

Mayzent (siponimod) is a disease-modifying treatment option for relapsing multiple sclerosis (MS) in adults. It can lower the chances of worsening MS and lower the number of MS relapses. Mayzent (siponimod) is a tablet that's taken by mouth. Common side effects include headache, high blood pressure, and falls. Mayzent (siponimod) is currently available as a brand-name only.

Indications for Mayzent

Relapsing forms of multiple sclerosis (MS)

Pros and Cons for Mayzent

Pros

Works well to slow worsening of MS and lower the number of MS relapses
Taken by mouth once per day
Doesn't require frequent visits to the clinic or infusion center to receive your dose

Cons

Requires several tests before starting (e.g., genetic testing, electrocardiogram, blood tests)
Might not be a good option for people with heart or serious liver problems
Not safe during pregnancy

Common Side Effects for Mayzent

Headache (15%)
High blood pressure (13%)
Higher liver enzyme levels in the blood (11%)
Falls (11%)
Swelling of the arms and legs (edema, 8%)
Nausea (7%)
Dizziness (7%)
Diarrhea (6%)
Low heart rate (6%)
Pain in arms or legs (6%)

Warnings for Mayzent

Infections
Eye problems
Slow heart rate
Breathing problems
Liver damage
Risk of skin cancer
Harm to unborn babies
Brain problem called posterior reversible encephalopathy syndrome (PRES)

Summary for Tysabri

Prescription only

Tysabri (natalizumab) is an injectable medication used to treat relapsing forms of multiple sclerosis (MS) in adults. It can also treat moderate-to-severe Crohn's disease (CD) in adults. It works as an integrin antagonist to help lower inflammation in the body. Tysabri (natalizumab) is given by a healthcare professional as an infusion into a vein once a month. Common side effects include headache and fatigue. Because it has a risk of serious infections, you must enroll in the Tysabri TOUCH Program before starting treatment.

Indications for Tysabri

Relapsing forms of multiple sclerosis (MS)
Moderate-to-severe Crohn's disease (CD) when other treatments haven't worked well

Pros and Cons for Tysabri

Pros

Infusions are once every month
Can help reduce relapses in MS
An option for Crohn's disease when other treatments haven't worked well

Cons

Must be given by a healthcare professional in a healthcare setting
Raises your risk of serious infection
Only FDA approved for adults

Common Side Effects for Tysabri

Headache (38%)
Fatigue or feeling very tired (27%)
Urinary tract infection (21%)
Joint pain (19%)
Depression (19%)
Lower respiratory tract infection (17%)
Pain in arm or leg (16%)
Rash or other skin irritation (up to 12%)
Stomach discomfort (11%)
Diarrhea (10%)

Warnings for Tysabri

Risk of a brain infection leading to progressive multifocal leukoencephalopathy (PML)
Risk of other infections
Liver problems
Allergic reaction or infusion reaction
Low platelet levels
Other lab changes