Multiple Sclerosis (cont.)
clatiramer (Copaxone), natalizumab (Tysabri), fingolimod (Gilenya), teriflunomide (Aubagio)
Glatiramer acetate (Copaxone) is a mixture of amino acids used to treat multiple sclerosis. Glatiramer acetate has been shown to decrease the relapse rates of multiple sclerosis by about one-third (if compared to patients receiving placebo) and appears to also have an effect on the overall progression of multiple sclerosis. Common side effects with Glatiramer acetate include a sensation of chest tightening following the injection, and injection site reactions which may include rare skin lesions referred to as lipoatrophy. Copaxone is given every day as an injection below the skin.
Natalizumab (Tysabri) is a monoclonal antibody that binds to white blood cells and interferes with their movement from the bloodstream into the brain and spinal cord. White blood cells are thought to play a role in causing the nervous system damage in multiple sclerosis. Tysabri decreases relapses by about two- thirds (if compared to patients receiving placebo) and reduces the accumulation of disability, but carries a warning for increasing the risk of progressive multifocal
encephalopathy (PML), a potentially fatal
brain infection. Because of this risk, Tysabri can only be given to patients that have registered for treatment under a controlled drug distribution program.
Fingolimod (Gilenya) is a daily oral medication to treat MS that was approved by the U.S. FDA in 2010 as the first oral medication to treat MS. Although the exact mechanism of action of fingolimod is unclear, it appears to work by reducing the number of lymphocytes (a type of white blood cell that is important for immunity and the inflammation process) in the blood. Like many injectable therapies for MS, the long-term safety of fingolimod is unknown. The most common side effects of fingolimod are
back pain, elevations of
liver enzymes in the blood, and
cough. Other side effects are also possible including
eye problems, so those taking this drug should have regular ophthalmologic evaluations.
Teriflunomide (Aubagio) is another newer oral medication for MS. This medication works by inhibiting dihydroorotate dehydrogenase, a mitochondrial enzyme involved in pyrimidine synthesis. Its side effects can include reduced white blood cell counts and liver problems. It is recommended that those taking this drug receive regular blood tests after beginning the medication.
Medically Reviewed by a Doctor on 6/2/2016
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