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DRAFT - The Disease Modifying Drugs

Information contained in this healthpage is from this publication: www.nationalmssociety.org/download.aspx?id=45, “The MS Disease Modifying” Drugs dated October 30, 2009.

 

 

The Disease Modifying Drugs

commonly referred to as DMDs or CRABs

 

The FDA approved new oral disease modifying therapy which is not included in this write-up at this time

 

 

 

Options

 

There are currently seven disease-modifying medications approved by the U.S. Food and Drug Administration (FDA) for use in relapsing forms of MS (including secondary progressive MS for those people who are still  experiencing relapses). They may work differently for everyone and none of them are a cure for MS. None will prevent recurring symptoms, such as fatigue or numbness, which typically come and go. All of them have proven records of partial to substantial success. Unfortunately, none of the currently available disease-modifying drugs are approved for treating primary  progressive MS — the type of MS that shows steady progression at onset.

 

Decisions about taking a disease-modifying drug are best made by carefully considering and weighing factors including individual lifestyles, known side effects, and the potential risks and benefits of the different therapies. A full discussion with a knowledgeable healthcare professional is the best

guide for your decision. Each person’s body or disease can respond to these medications in different ways.

 

The following charts sort out and present some of the relevant facts. Rebif®, Copaxone®, Betaseron®, Extavia® and Avonex® are self-injectable drugs for long-term use; they modulate the immune system, which means they adjust or modify how the immune system functions. Tysabri®, which is also an immune-modulating drug, is delivered by IV infusion (into the vein) at a registered infusion facility. Novantrone® is a powerful immune system suppressor, delivered by IV infusion in a medical setting.

 

 

 

 

 

Benefits of the Disease-Modifying Drugs

 

Reducing the frequency and severity of attacks

Most people using a disease-modifying drug have fewer

and less severe MS attacks (relapses or exacerbations). In

individual clinical trials comparing a drug versus an inactive

placebo treatment, MS attacks were reduced by 28–68

percent by different agents. In addition, most people were

found to have fewer, smaller, or no new lesions developing

within their central nervous system as visible in MRI scans.

 

Preventing permanent damage

Permanent damage to nerve fibers (called axons) occurs

early in MS in association with the destruction of myelin.

Overall brain shrinkage (or atrophy), can occur early in the

disease, and damage can be ongoing even when the person

has no symptoms of an attack and feels well. Therefore,

MS specialists advise the early use of a drug that effectively

limits lesion formation and brain atrophy, or shrinkage. In

the opinion of the National MS Society’s Clinical Advisory

Board, limiting lesions may be a key to reducing future

permanent disability for many people with MS.

 

 

 

 

 

 

 

 

 

Indications:

 

 

Copaxone

 

Rebif

 

Avonex

 

Extavia

 

Betaseron

 

Novantrone

 

Tysabri

 

 

For the treatment of relapsing-remitting MS ; and for patients

who have experienced a first clinical episode and have MRI

features consistent with MS .

 

 

 

For the treatment of relapsing forms of MS.

 

For the treatment of relapsing forms of MS, and for a first clinical

episode if MRI features consistent with MS are also present.

 

Extavia For the treatment of relapsing forms of MS and secondary progressive

MS with relapses; and for patients who have

experienced a first clinical episode and have MRI features.

 

 

For the treatment of relapsing forms of MS and secondary progressive

MS with relapses; and for patients who have

experienced a first clinical episode and have MRI features

consistent with MS .

 

Four times a year by IV infusion in a medical facility. Lifetime

cumulative dose limit of approximately 8–12 doses over 2–3

years (140 mg/m2).

 

For the treatment of relapsing forms of MS as a monotherapy

(not used in combination with any other disease-modifying

medication). Generally recommended for patients who have

had inadequate response to, or are unable to tolerate, another

disease modifying medication.

 

 

 

 

 

 

 

 

 

Common Side Effects

(Always inform your healthcare professional of side effects)

Immunomodulating drugs

Avonex®

Flu-like symptoms following injection, which lessen over time

for many. (See “Managing side effects” on page 9.) Less common:

depression, mild anemia, liver abnormalities*, allergic reactions,

heart problems.

Betaseron®

Flu-like symptoms following injection, which lessen over time for

many. (See “Managing side effects on page 9.) Injection site

reactions, about 5% of which need medical attention. Less

common: allergic reactions, depression, liver abnormalities*,

low white blood cell counts.

 

http://www.medhelp.org/posts/Multiple-Sclerosis/DMD-Users-Past--Present---Copaxone--Rebif--Avonex--Betaseron--Tysabri--other/show/1193746

 

Copaxone®

Injection site reactions. Less common: vasodilation (dilation of

blood vessels); chest pain; a reaction immediately after injection,

which includes anxiety, chest pain, palpitations, shortness of

breath, and flushing. This lasts 15-30 minutes, passes without

treatment, and has no known long-term effects. 

Extavia®

Flu-like symptoms following injection, which lessen over time

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