Multiple Sclerosis Drugs - Exploring Your Options

Learn more about Betaseron, Copaxone and Other MS Drugs

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Multiple sclerosis drugs can alter the course of multiple sclerosis by slowing the progression of the disease. And since my diagnosis, I have heard more than once that I picked a great time to have multiple sclerosis because of the variety of MS drugs now out on the market. Betaseron, Copaxone, Avonex and others work to modify the disease, but are all different from one another to some degree. Before working with your doctor to choose an MS drug that is right for you, you should review the differences in these medications carefully.

It is just since the mid-1990s that there has been any treatment for multiple sclerosis itself – prior to this, doctors and patients relied on corticosteroids to shorten relapses, medications to address different symptoms, and physical and occupational therapy to adjust to and slow disability. The disease-modifying drugs have been shown to do just what they claim – modify the actual course of MS. They do this by reducing the number and frequency of new lesions, especially the ones that cause relapses.

Some Considerations

One thing to remember when looking at the different medications is that effectiveness is reported based on a two-year period. However, longer-term data is starting to become available for some of the older drugs (Copaxone, Avonex, Betaseron and Rebif), and the results seem to support the assertion that these drugs are even more effective over a longer period.

There are many considerations when deciding which therapy to begin, including: side effects, type of MS you have, ease of use and any necessary monitoring.

Your neurologist will probably have an opinion on which therapy he thinks will be best for you, based on the considerations mentioned, as well as his own experience with patients like you.

Avonex

Avonex (interferon beta-1a) is a copy of interferon-beta, which is a protein component that your body makes.

It works by reducing the immune response that can attack nerve cells in your body.

  • Which Type of MS is it for? Relapsing-remitting MS and sometimes for people suspected to have MS.
  • How Effective is it? It reduces the relapse rate by 30 percent.
  • How is it Taken? Once a week by intramuscular injection, usually given at home.
  • Storage: Prefilled syringes can be kept unrefrigerated for up to 7 days. (Powder form can be stored at room temperature for up to 30 days, but must be refrigerated once mixed).
  • Precautions: Be sure to tell your doctor if you have had depression, anxiety, trouble sleeping, thyroid problems, blood problems (bleeding, easy bruising, anemia, low white cell count), seizures, heart problems or liver disease. If you are pregnant (or might become pregnant), you should not use Avonex
  • What are the Side Effects? Flu-like symptoms during the initial weeks. These symptoms may continue longer. Less common are depression and liver dysfunction.
  • When was it approved? 1996
  • More Information and Patient Support: Avonex ActiveSource; Avonex; phone: 1-800-456-2255

    Betaseron

    Betaseron (interferon beta-1b) is a medication made from interferon beta, which is a protein component that your body makes. It works by reducing the immune response that can attack nerve cells in your body.

    • Which Type of MS is it for? Relapsing-remitting and progressive-relapsing.
    • How Effective is it? It reduces the relapse rate by 30 percent.
    • How is it Taken? Subcutaneous (under the skin) injection every other day. Usually done at home.
    • Storage: No special storage needed.
    • Precautions: Cannot be used while pregnant. Birth control is recommended for sexually active women taking Betaseron. Routine blood tests may be used to monitor liver, thyroid and blood counts.
    • What are the Side Effects? Flu-like symptoms during the initial weeks. These symptoms may continue longer. Injection site reactions may also occur including swelling, redness, and pain. Injection sites must be rotated. Can also cause depression.
    • When was it approved? 1993
    • More Information and Patient Support: MS Pathways; Betaseron; phone: 1-800-788-1467

    Copaxone

    Copaxone (glatiramer acetate) is a compound made up of amino acids. These amino acids, which are also found in myelin, are thought to help switch the immune system from causing inflammation around lesions to reducing inflammation.

    • Which Type of MS is it for? Relapsing-remitting.
    • How Effective is it? It reduces the relapse rate by 30 percent.
    • How is it Taken? Subcutaneous (under the skin) injection every day. Usually done at home.
    • Storage: Can be kept unrefrigerated up to 30 days. It is light-sensitive.
    • Precautions: Not recommended for use during pregnancy.
    • What are the Side Effects? Injection site reactions may occur, including swelling, redness and pain. Injection sites must be rotated.
    • When was it approved? 1996
    • More Information and Patient Support: Shared Solutions; phone: 1-800-887-8100

    Sources:

    Multiple Sclerosis: Hope Through Research ; National Institute of Neurological Disorders and Stroke

    Rebif

    Rebif (interferon beta-1a) is a copy of a type of interferon that your body produces. These interferons are proteins that can modify how your immune systems reacts to nerve cells.
    • Which Type of MS is it for? Relapsing-remitting.
    • How Effective is it? It reduces the relapse rate by 30 percent.
    • How is it Taken? Subcutaneous (under the skin) injection three times a week. Usually done at home.
    • Storage: Can go 30 days without refrigeration. It is also light-sensitive.
    • Precautions: Not recommended for use during pregnancy or breast-feeding.
    • What are the Side Effects? Flu-like symptoms during the initial weeks. You doctor may schedule blood tests to assure that the medication has not affected liver function, blood counts or thyroid function.
    • When was it approved? 2002
    • More Information and Patient Support: MS LifeLines; Rebif phone: 1-877-44-REBIF

    Novantrone

    Novantrone (Mitoxantrone) is an antineoplastic, a type of medication first used in cancer treatment. Novantrone works in MS by suppressing immune system elements that may attack the myelin.
    • Which Type of MS is it for? Secondary-progressive, progressive-relapsing and some types of relapsing-remitting.
    • How Effective is it? In a 2-year study, compared to a placebo, Novantrone has been shown to reduce the number of relapses, lengthen time between relapses, show a 61 percent reduction in the deterioration of study participants’ ability to walk and significantly less neurological disability.
    • How is it Taken? IV infusion once every three months at the doctor’s office or other treatment site. Because of the potential for cardiac damage, patients can only take up to a maximum cumulative dose of 140 mg/m2 (approximately 8-12 doses) over 2-3 years.
    • Precautions: Prior to treatment patients must be evaluated for cardiac problems. A person with a history of cardiac problems, certain medications, and previous use of chemotherapies may not be able to use Novantrone. Because Novantrone lowers your immune response, you should take precautions to avoid infection. Always check with your doctor before taking any immunizations. Novantrone should not be used while pregnant or breastfeeding.
    • What are the Side Effects? Nausea, hair loss, menstrual disorders. If fever, chills, pain or other symptoms occur, you should tell your doctor.
    • When was it approved?2000
    • More Information and Patient Support: MS LifeLines; phone: 1-877-447-3243

    Tysabri

    Tysabri (Natalizumab) is a monoclonal antibody that makes it more difficult for the cells of the immune system to move into the brain and spinal cord.
    • Which Type of MS is it for? Relapsing-remitting MS that has not responded to other treatments.
    • How Effective is it? It reduces MS relapse rate by 60 percent.
    • How is it Taken? IV once every four weeks at the doctor’s office or other treatment site.
    • Precautions: Tysabri increases the risk of a viral infection of the brain called progressive multifocal leukoencephalopathy (PML) which leads to severe disability or death. Because of this, a complex monitoring system is set up for people taking Tysabri. People with a weakened immune system should not take Tysabri. Tysabri should not be used by pregnant or breastfeeding women. Precaution should be taken to avoid infection.
    • What are the Side Effects? headache, pain, fatigue, depression, diarrhea. Allergic reactions may occur.
    • When was it approved? 2006
    • More Information and Patient Support: Biogen, Idec, Inc.; phone: 1-800-456-2255

    Sources:

    Multiple Sclerosis: Hope Through Research ; National Institute of Neurological Disorders and Stroke

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