What is Multiple Sclerosis MS

Multiple sclerosis (MS) is a chronic disease which affects the brain and spinal cord. MS can cause a variety of symptoms, including changes in sensation, visual problems, muscle we...

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Discussion:
History of Copaxone.
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From the Nuerology Now Sept/Oct Edition

Q: Why is Glatiramer Acetate therapies prescribed for multiple sclerosis (MS)? According to Cochrane Collaboration, the evidence does not support use of these therapies.

A: Glatiramer Acetate (Copaxone) is one of four FDA approved injectable medications for relapsing-remitting MS. An assortment of four amino acids (the building blocks of our bodies), glatiramer acetate was originally developed to give laboratory animals a disease similar to MS called experimental autoimmune encephalomyelitis (EAE). When glatiramer acetate failed to cause EAE in the mice, investigators gave it to mice that already has the disease, and it helped improve their symptoms. After much laboratory and animal research, clinical trials were started in human MS patients. There were some flaws in the statistical methods used in these trials, and so the Cochrane Collaboration-- an international non-profit organization that reviews trials (Cochrane.org) --decided that these were not the best trials to support it's use.
However, since the Cochrane Review was published, we have learned much more about glatiramer acetate, including how it works, the long-term benefits of staying on therapy, and even how it compares to beta interferons, the other class of injectable medications for MS. This also highlights how far we have come with MS medications; before 1993 there were no medicines for the condition, and now we have four injectable medications, two intravenous (IV) medicines, and dozens of ongoing clinical trials of IV and oral medicines. We have also come a long way in the methods we use to design the clinical trials, which only gave us a hint as to the full power of these medications.

Daniel Kantor, M.D., is assistant professor of neurology and director of the Comprehensive Multiple Sclerosis Center at the University of Florida in Jacksonville, FL.
Posted on 10/08/08, 08:10 pm
16 Replies | Most Recent Add Your Reply
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Reply #1 - 10/08/08  8:27pm
" Whew, i just typed all that out. My arm hurts. "
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Reply #2 - 10/08/08  8:29pm
" I was going to say Boo you really are typing a lot today!! "
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Reply #3 - 10/08/08  8:36pm
" I am confused. Does this paper say that Copaxone does not do us good? I do not see it. "
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Reply #4 - 10/08/08  9:41pm
" thats so interesting and i am so glad you put this up! I am trying to decide on a treatment right now. "
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Reply #5 - 10/09/08  9:13am
" While it doesn't say that Copaxone isn't good (A doctor can't say that in a national publication.. he'd lose so much money from the drug companies) Copaxone has been shown to have the lowest efficacy of any MS injectable therapy. "
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Reply #6 - 10/09/08  3:08pm
" Yes, I agree with Boo about Copaxon most likely being the least effective. I've never used it, the reason being it wasn't out when I started my med of choice.

The thing is, for one reason or another, some folks can't use the interferons, so this is a good choice for them. And, for those who take it, and find it does help, I'm thankful it's out there for them.

My guess would be this is another thing we all need to research, and then talk with our docs about. I'm just so glad there are more and more options as time goes by! "
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Reply #7 - 10/09/08  3:48pm
" Interesting & thought provoking Boo. A little of "word of mouth information" I got about copaxone...it was fda approved in the US in 1996. Betaseron was first in the US in 1993. But before 1993 it was in use in Isreal. A person with MS at the time before 1993, said that people with $ were going outside the US to get treatment for MS...
With Copaxone.

By observation of posts in MS boards, it seems like some people being treated with copaxone will get a rather severe MS episode.

But it also helps others so much too?

I guess I started with betaseron & I'm slightly leary of copaxone. I told you what my diagnosing doc said. He would not consider copaxone. He would only prescribe one of the interferon's. He said the interferens harness the immune system, which we know is causing the problem. Copaxone just provides fake decoy's for the immunse system to attack in the hopes that the fake myelin will be attacked before the real myelin. Thereby slowing the disease.

My diagnosing doc said we will harness what we know is causing the problem, not give the problem more practice at doing the wrong thing.

What are the 2 IV treatments...Tysabri or Steroids? What's that second IV? Did I miss siomething? "
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Reply #8 - 10/09/08  5:38pm
" Tysabri seems to be the most effective. It twice as effective as the CRAB drugs which only reduce the number of flare ups by 30%.....I heard that news and decided it probably wasnt worth the potential liver damage and side effects, especially if I have a less serious course of illness.

Tysabri has double the effectiveness, but a lot of doctors are hesitant to prescribe it because of the 0.1% chance of an fatal brain infection, susceptibility to disease, and severe allergic reactions that can require hospitalization.

Its not always an easy decision choosing a medication or whether you want to medicate.

I decided for me personally (Not in general for everybody) that if I am having less than 1 attack per year, which I fully recover from, I will avoid using any injectable medication for as long as I can. "
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Reply #9 - 10/09/08  8:14pm
" Yup it's 68%.. I like those numbers. "
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Reply #10 - 10/09/08  9:15pm
" I did some investigation. This is an extremely old article, and not current. Notice that the date of the publication is not included, but only the month. Clever.
The Cochrane review was published several years ago and omitted much of the Copaxone trial information. It also included an old secondary progressive trial that was not positive and Teva Neuroscience (the manufacturers of Copaxone) never claimed it to be and has never marketed the drug for SPMS.

The recent head to head trials of Copaxone vs Betaseron (single and double dose) and vs Rebif showed virtually identical results and even stalwart interferon supporters including Dr. Douglas Goodin of UCSF ( one of the most esteemed and competent MS neurologists in the country) now consider the drugs to be therapeutically equivalent. "

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