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In the last several years, three new drugs/treatments were introduced for patients with the relapsing-remitting form of Multiple Sclerosis (MS): Avonex®, Betaseron®, and Copaxone®. Are these drugs – or any one of them – the answer?
According to a number of studies, three drugs marketed under the brand names Avonex®, Betasaron®, and Copaxone® have all shown potential for reducing the number of MS exacerbations or attacks and slowing the progression of the disease in a person with the relapsing-remitting form of the disease. All of these drugs – commonly known as the ABC drugs – are approved for use in the United States. There are no generic replacement drugs currently available. All three drugs are administered by injection, although testing on oral forms of some of the drugs is in progress.
Avonex® is the brand name for the chemical interferon beta-1a. It was approved by the Federal Drug Administration (FDA) in May 1996. It is administered once a week, and common side effects include flu-like symptoms. More rarely, side effects like mild anemia and elevated liver enzymes may also occur. The annual cost of treatment with Avonex® is slightly over $10,100.
Betasaron® is the brand name for the chemical interferon beta-1b, the first interferon to be approved in the United States for the treatment of MS. It was approved by the FDA in September 1994 and is administered every other day. Common side effects also include flu-like symptoms. Patients may also experience reactions at the injection site, and about 5 percent of these patients may need medical attention. More rare side effects include elevated liver enzymes and low white blood cell counts. Treatment with Betasaron® costs approximately $10,000 annually.
Copaxone® is the brand name for glatiramer acetate. It was approved by the FDA in December 1996 and is administered daily. The patient rotates between injection sites to reduce the risk of injection site reactions. However, injection site reactions are still the most common side effect. More rarely, patients may experience anxiety, chest tightness, shortness of breath, and flushing that can last 5 to 30 minutes after the injection. Treatment with Copaxone® costs approximately $9,800 per year.
According to the National Multiple Sclerosis Society (NMSS), large studies comparing the three drugs to one another do not currently exist. Clinical trials have shown all three drugs to reduce exacerbations by up to 30 percent. The NMSS’s Medical Advisory Board considers the drugs generally comparable.
While about 20 percent of patients using Avonex® or Betaseron® develop a resistance to the drug, sometimes doctors feel more comfortable recommending one of these drugs because they have been studied longer and more intensively than Copaxone® and their use is more established. Copaxone® is a newer treatment, but so far advantages include fewer side effects and less chance of becoming neutralized.
Only a physician can recommend the best course of therapy for an individual with MS. However, in November 1998, the NMSS issued a consensus statement saying, “The National Multiple Sclerosis Society strongly recommends that people with relapsing-remitting MS see their physician about starting one of the MS drug treatments now available – the sooner the better.”
Not all doctors agree, because some patients may never experience significant disability and may not need medication, but the fact is, there is no way to tell which patients will experience a mild form of the disease and which patients may become partially or significantly disabled. In the end, MS patients themselves must weigh all the evidence, talk with their individual physicians, and make a decision for themselves.
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