Disease Modifying Medications for Multiple Sclerosis

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As
of right now (October of 2012) there are 9 FDA approved medications
for Multiple Sclerosis (MS), they are all oral, injectable, or
intravenous (IV). These medications are known as DMT’s (Disease
Modifying Treatments) or DMD’s (Disease Modifying Drugs). The
following is a chart showing some basic info on these medications:

Name Type How Often FDA Approval
Aubagio (teriflunomide) Oral Once a Day 2012
Avonex (interferon beta-1a) Intramuscular Injection Once a Week 2003
Betaseron (interferon beta-1b) Subcutaneous Injection Every Other Day 1993
Rebif (interferon beta-1a) Subcutaneous Injection 3X a Week 2002
Copaxone (glatiramer acetate) Subcutaneous Injection Everyday 1997
Extavia (interferon beta-1b) Subcutaneous Injection Every Other Day 2009
Gilenya (fingolimod)   Oral Once a Day 2010
Novantrone (mitoxantrone) IV Every 3 Months 2000
Tysabri (natalizumab) IV Every 4 Weeks
2004
Common Side Effects:

Name
Common Side Effects
More Info
Headache,
elevations in liver enzymes, hair thinning, diarrhea, nausea,
neutropenia (a condition that reduces the number of certain white
blood cells), and paresthesia (tingling, burning, or numbing
sensation)
More severe
adverse events include the risk of severe liver injury and the
risk of birth defects if used during pregnancy. With regard to
liver injury, blood tests for liver function must be performed
within six months prior to starting Aubagio, and then every month
for the first six months. With regard to pregnancy, Aubagio may
only be prescribed to women of childbearing years if they are
using reliable birth control. If liver damage is detected, or if
someone becomes pregnant while taking this drug, accelerated
elimination of the drug is prescribed. This removes more than 98
percent of the drug within 11 days.
Flu-like
symptoms and headache
Side effects
may be prevented and/or managed effectively through various
treatment strategies; side effect problems are usually temporary.
Blood tests may be given periodically to monitor liver enzymes,
blood-cell counts, and neutralizing antibodies.
Flu-like
symptoms, injection-site skin reaction, blood count and liver test
abnormalities
Side effects
may be prevented and/or managed effectively through various
treatment strategies; side effect problems are usually temporary.
Blood tests may be given periodically to monitor liver enzymes,
blood-cell counts, and neutralizing antibodies.
Flu-like
symptoms, injection-site skin reaction, blood count and liver test
abnormalities
Side effects
may be prevented and/or managed effectively through various
treatment strategies; side effect problems are usually temporary.
Blood tests may be given periodically to monitor liver enzymes,
blood-cell counts, and neutralizing antibodies.
Injection-site
skin reaction as well as an occasional systemic reaction –
occurring at least once in approximately 10 percent of those
tested
Systemic
reactions occur about five to 15 minutes following an injection
and may include anxiety, flushing, chest tightness, dizziness,
palpitations, and/or shortness of breath. Usually lasting for only
a few minutes, these symptoms do not require specific treatment
and have no long-term negative effects.
Flu-like
symptoms, injection-site skin reaction, blood count and liver test
abnormalities
Side effects
may be prevented and/or managed effectively through various
treatment strategies; side effect problems are usually temporary.
Blood tests may be given periodically to monitor liver enzymes,
blood-cell counts, and neutralizing antibodies.
Headache, flu,
diarrhea, back pain, abnormal liver tests and cough
Adverse events
include: a reduction in heart rate (dose-related and transient);
infrequent transient AV conduction block of the heart; a mild
increase in blood pressure; macular edema (a condition that can
affect vision, caused by swelling behind the eye); reversible
elevation of liver enzymes; and a slight increase in lung
infections (primarily bronchitis). Infections, including herpes
infection, are also of concern.
Usually well
tolerated; side effects include nausea, thinning hair, loss of
menstrual periods, bladder infections, and mouth sores;
additionally, urine and whites of the eyes may turn a bluish color
temporarily
Novantrone
carries the risk of cardiotoxicity (heart damage) and may not be
given beyond two or three years. People undergoing treatment must
have regular testing for cardiotoxicity, white blood cell counts,
and liver function. Novantrone was studied in combination with
large IV doses of steroids. Concurrently, many physicians often
use it in combination with one of the interferons or Copaxone.
Headache,
fatigue, depression, joint pain, abdominal discomfort, and
infection
Risk of infection (including pneumonia) was the most common serious
adverse event during the studies (occurring in a small percentage of
patients). The TOUCH Prescribing Program monitors patients for signs of
PML, an often-fatal viral infection of the brain.
Thanks To MSSA

These
medications do not cure Multiple Sclerosis, as the term DMD implies,
they only “modify” the course of the disease, they are simply
meant to reduce the number of flare up’s or exacerbations a Patient
has. Some of these drugs may even reduce the long term permanent
disability effects of MS but recently, the interferon based
medications might have been crossed off that list…

“After
accounting for confounders including age, disease duration, and
baseline EDSS score, treated patients were a nonsignificant 1.3-fold
more likely to progress than the untreated group. But compared with a
group of 959 historical patients (10.8 years follow up), who had MS
before interferon beta became available, treated patients were a
nonsignificant 23% less likely to progress.”

Derfuss
and Kappos say the findings “reinforce the conclusion that the
associations between use of interferons and long-term disability,
although plausible, remain unproven.”

READ MORE HERE

Many
of the new DMD’s that are being FDA approved are oral as most people
do not like giving themselves a shot (surprisingly) but in my
opinion, an injection is a much better delivery method as the medication
does not have to be digested first like a pill does…
Most
people (Patients and Doctors) would agree that it is very important
to get on a DMD as soon as possible.

3 Responses to Disease Modifying Medications for Multiple Sclerosis

  1. Damien Byrne says:

    You have used the same for Gilenya as for Tysabri in the more info section of the chart. Thank you for sharing.
    D Byrne

  2. Matt Allen G says:

    Oops, thanks for pointing that out, was getting tired hahaha. Fixed it, thanks!

  3. Anonymous says:

    Matt, off topic, how is your vision, is it still double, has it improved any? I hope so.

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