Extended use of glatiramer acetate (Copaxone) is well tolerated and maintains its clinical effect on multiple sclerosis relapse rate and degree of disability

Johnson, Kenneth P.; Brooks, Benjamin; Cohen, Jeffrey A.; Ford, Corey C.; Goldstein, Jonathan; Lisak, Robert P.; Myers, Lawrence W.; Panitch, Hillel S.; Rose, John; Schiffer, Randolph B.; Vollmer, Timothy; Weiner, L. P.; Wolinsky, J. S.

doi:10.1212/wnl.50.3.701

Cited by 483 publications

(305 citation statements)

References 9 publications

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“…[19][20][21][22][23][24][25][26] Interferon beta-1b SC has been shown to delay sustained neurologic deterioration in patients with secondary progressive MS (SPMS). 27 Effective communication between the MS patient and the prescribing neurologist is essential in making decisions regarding the initiation and continuation of DMTs.…”

Section: Discussionmentioning

confidence: 99%

Adherence to First-Line Disease-Modifying Therapy for Multiple Sclerosis in Kuwait

Alroughani

Thussu

2012

International Journal of MS Care

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The aim of this retrospective study was to determine the rate of nonadherence to disease-modifying therapies (DMTs) among multiple sclerosis (MS) patients in Kuwait and to identify reasons for patient discontinuation of long-term therapy. Using a newly established MS registry at our institution, we collected data on MS patients' demographics, clinical characteristics, disability measures, and continuation or discontinuation of first-line DMTs. Reasons for nonadherence were divided into four categories: adverse events, inconvenience, perceived lack of efficacy, and physician-documented disease progression. Of 212 eligible patients, 40.1% were found to be nonadherent to first-line DMTs. In the nonadherent group, the female-to-male ratio was 1.75:1 and the mean age at disease onset was 26.8 years. Of this group, 69.4% of patients had a relapsing-remitting course, 18.8% had a secondary progressive course, and 11.8% had clinically isolated syndrome. Compared with the adherent group, the nonadherent group had a shorter mean disease duration (P = .014) and a greater likelihood of having Expanded Disability Status Scale (EDSS) scores of 3 or lower (67.1% vs. 48.0%; P = .007). Inconvenience was the most common reason for nonadherence (32.9%), followed by perceived lack of efficacy (25.9%), adverse events (23.5%), and physician-documented disease progression (17.7%). In summary, the rate of nonadherence to first-line DMTs in MS patients at our institution is considered high. Most nonadherent patients had a short disease duration and low EDSS scores. Inconvenience and perceived lack of efficacy were the most common reasons for nonadherence. The results demonstrate a need to improve treatment adherence among MS patients in Kuwait through providing better patient education, improving communication between patients and health-care providers, defining therapy expectations, and instituting new therapeutic techniques. Int J MS Care. 2012;14:17-24.

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Section: Discussionmentioning

confidence: 99%

Adherence to First-Line Disease-Modifying Therapy for Multiple Sclerosis in Kuwait

Alroughani

Thussu

2012

International Journal of MS Care

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“…Based on this data, GA was approved by the FDA in December 1996. In 1998, the extension of the same trial was published [85]. During the original 2 year core study, it was decided to continue all participants within their arms until the last had reached the 2 year point.…”

Section: Relapsing Remitting Msmentioning

confidence: 99%

Interferon Beta and Glatiramer Acetate Therapy

McGraw

Lublin

2013

Neurotherapeutics

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“…More recently, GA was also shown to inhibit type II collagen-reactive T cells in vitro (23) and to prevent graft vs host disease (24,25) and transplant rejection (26). The potential of GA as a therapeutic agent in multiple sclerosis (MS) has been further substantiated by the reduction of relapse frequency in relapsing-remitting MS patients and by the reduced appearance of new lesions in gadolinium-enhanced magnetic resonance imaging (27)(28)(29)(30).…”

Section: Endritic Cells (Dc)mentioning

confidence: 99%

Glatiramer Acetate (Copolymer-1, Copaxone) Promotes Th2 Cell Development and Increased IL-10 Production Through Modulation of Dendritic Cells

Vieira¹,

Heystek²,

Wormmeester³

et al. 2003

The Journal of Immunology

201

145

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Glatiramer acetate (GA; copolymer-1, Copaxone) suppresses the induction of experimental autoimmune encephalomyelitis and reduces the relapse frequency in relapsing-remitting multiple sclerosis. Although it has become clear that GA induces protective degenerate Th2/IL-10 responses, its precise mode of action remains elusive. Because the cytokine profile of Th cells is often regulated by dendritic cells (DC), we studied the modulatory effects of GA on the T cell regulatory function of human DC. This study shows the novel selective inhibitory effect of GA on the production of DC-derived inflammatory mediators without affecting DC maturation or DC immunostimulatory potential. DC exposed to GA have an impaired capacity to secrete the major Th1 polarizing factor IL-12p70 in response to LPS and CD40 ligand triggering. DC exposed to GA induce effector IL-4-secreting Th2 cells and enhanced levels of the anti-inflammatory cytokine IL-10. The anti-inflammatory effect of GA is mediated via DC as GA does not affect the polarization patterns of naive Th cells activated in an APC-free system. Together, these results reveal that APC are essential for the GA-mediated shift in the Th cell profiles and indicate that DC are a prime target for the immunomodulatory effects of GA.

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Extended use of glatiramer acetate (Copaxone) is well tolerated and maintains its clinical effect on multiple sclerosis relapse rate and degree of disability

Cited by 483 publications

References 9 publications

Adherence to First-Line Disease-Modifying Therapy for Multiple Sclerosis in Kuwait

Adherence to First-Line Disease-Modifying Therapy for Multiple Sclerosis in Kuwait

Interferon Beta and Glatiramer Acetate Therapy

Glatiramer Acetate (Copolymer-1, Copaxone) Promotes Th2 Cell Development and Increased IL-10 Production Through Modulation of Dendritic Cells

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