Choosing the right DMD...

[zoefromsussex]

Hello everyone, I hope those of you reading this post have had a good weekend? I was hoping to get some tips on choosing a dmd. I've recently been diagnosed with RRMS which has mainly been severe ON with milder symptoms elsewhere (so far!) Anyway, I haven't started a dmd yet because I'm trying to stop b/feeding my son first but I'm due to see the MS nurse in a couple of weeks, where we will make a decision about my treatment. All along I've had it in the back of my mind that Copaxone will be my first choice of drug because it's a daily injection (less likely to forget), there aren't flu-like side effects and the risk of liver damage is less (my dad died of liver failure after taking immunosuppressants) The only thing putting me off is the injections themselves as I've got very bad hyperhidrosis in my hands and am scared the needle will slip or something. Would Tysabari be a better choice for me in that case? Help please!
Thanks Zoe

[sllowe]

Hi Zoe,

Sounds like you have the lifestyle changed figured out for yourself (i.e., adding in a shot a day). And, copax has an auto injector as well I do believe. That should help with administering it.

I recommend your husband sit in on the teaching when the nurse comes to show you how to do it. That way, he can learn as well for those off days.
Nice to see you are moving foward toward treatment :)
-shell

[Sidesteps]

I think it really is a very personal choice. I can see why you would choose Copaxone if you are concerned with liver damage.

Alternatively, is it possible that your doctor would be willing to monitor your liver a bit more closely in choosing Avonex?

[Mummy76]

Hi Zoe,

It seems quite a few of us are trying to make this decision right now!  I`ve finally decided on Copaxone, for some of the reasons you`ve said, and because I have had depression in the past so I don`t want to make it worse.  My main symptom is also ON.  I am advising my neurologist today of which DMD I`d like to start, I`ll let you know how it goes!

Good luck in making your choice!

[SarahL2491]

Jus remember that the purpose of DMD drugs is to help prevent future episodes, not take care of what has happened or your little aggrevating symptoms that just bug us........

someone told me once its like buying life insurance.......you are investing in your future........

all of them appear to have good and bad points.  My neuro chose for me so I did not have the problem.  Also our drug system here in the states is set up also helped him convince me it was the way to go as DMD drugs are expensive.

I hear good things about the auto inject features from those who use them
Good luck!

[zoefromsussex]

Thanks. I'm hoping my neuro will agree to an mri so we can see whether any further damage has occurred. Otherwise I kind of feel that I am fine so maybe don't need a dmd?

[maxthecat43]

I agree with TLC, If you have trouble with handling the needle, you should use the auto injector.  You will probably need to anyway, because since you are going to be injecting everyday you will need to use all your injection sites.  Some of them are very challenging with the auto injector...  

Alternatively, I recommend Avonex.  It's only once a week, so maybe the liver problems are reduced?  And the flu symptoms aren't that bad.  My neurologist gives me 10mg of oral prednisone to premedicate with.  That along with ibuprofen, and lots of water for one day- that's all for most people.

Good luck!
Tammy

[TLC_31]

I normally tell people that there is no wrong choice, because patients respond differently to these medications. However, if there is a genetic component to your dad's illness, yes that has to raise a red flag for the interferons.

Otherwise, the flu-like side effects of the interferons can be minimized. And copaxone has its own side effects. But it is a time-tested first-line treatment with a high safety and efficacy profile. I suspect your gut feeling is correct, and perhaps the autoinjector would mitigate the hyperhidrosis.