Therapy with glatiramer acetate for multiple sclerosis

Abstract

Glatiramer acetate did not show any beneficial effect on the main outcome measures in MS, i.e. disease progression, and it does not substantially affect the risk of clinical relapses. Therefore its routine use in clinical practice is not currently supported. More investigations are needed. Further research should also develop more reliable measures of patient disability over time and include quality of life among primary outcomes.

The efficacy of glatiramer acetate in beta-interferon-intolerant MS patients

“…None of the patients stopped GA therapy due to the lack of efficacy but rather because of side effects, which emphasizes the need for development of new therapeutic options for the treatment of MS. The most commonly reported adverse effects, injection‐site reactions and chest tightness, were similar to those observed in earlier trials with GA (3, 8, 10). Considering the selected patient population in this study, the discontinuation rate of 27% was lower than anticipated, but approximately at the same level as observed in a 6‐year GA trial (8).…”

The efficacy of glatiramer acetate in beta-interferon-intolerant MS patients

“…None of the patients stopped GA therapy due to the lack of efficacy but rather because of side effects, which emphasizes the need for development of new therapeutic options for the treatment of MS. The most commonly reported adverse effects, injection‐site reactions and chest tightness, were similar to those observed in earlier trials with GA (3, 8, 10). Considering the selected patient population in this study, the discontinuation rate of 27% was lower than anticipated, but approximately at the same level as observed in a 6‐year GA trial (8).…”

Efficacy, safety, and cost-effectiveness of glatiramer acetate in the treatment of relapsing–remitting multiple sclerosis

“…A more recent Cochran meta-analysis, however, concluded that GA had no effect on MS disease progression [Munari et al 2004]. Their conclusion was consistent with results from a prospective, randomized, placebo-controlled trial of 943 primary progressive MS (PPMS) patients (PROMiSe Trial) that failed to show a treatment effect of GA to slow disease progression (HR 0.87; 95% CI ¼ 0.711.07; p ¼ 0.175).…”

Experimental allergic encephalomyelitis: A misleading model of multiple sclerosis

“…The spectrum of agents and approaches that showed promising results in EAE is immense and range from turmeric (used in Asian cooking) and Padma-28 (exotic natural drug found in health food stores) to modern genetic manipulation of the immune system with cytokines and antigen. 63 Glatiramer acetate is modestly effective in reducing relapses but has not prevented the progression of MS. 64 The reasons for this failure are not only, as shown here, that MS and EAE differ quite substantially, but also that even from the larger, more comprehensive picture, most of the evidence suggests that the EAE models do not reflect the pathology of a progressive disorder as MS. 61,62 Glatiramer acetate represents the only drug currently in use whose application in a clinical setting was first proved useful in EAE.…”

“…61,62 Glatiramer acetate represents the only drug currently in use whose application in a clinical setting was first proved useful in EAE. 63 Glatiramer acetate is modestly effective in reducing relapses but has not prevented the progression of MS. 64 The reasons for this failure are not only, as shown here, that MS and EAE differ quite substantially, but also that even from the larger, more comprehensive picture, most of the evidence suggests that the EAE models do not reflect the pathology of a progressive disorder as MS. Moreover, the various EAE models are dissimilar in their pathology and immunology to such an extent that it is unclear why one EAE model will be better served than another.…”

The efficacy of glatiramer acetate in beta-interferon-intolerant MS patients

“…None of the patients stopped GA therapy due to the lack of efficacy but rather because of side effects, which emphasizes the need for development of new therapeutic options for the treatment of MS. The most commonly reported adverse effects, injection‐site reactions and chest tightness, were similar to those observed in earlier trials with GA (3, 8, 10). Considering the selected patient population in this study, the discontinuation rate of 27% was lower than anticipated, but approximately at the same level as observed in a 6‐year GA trial (8).…”

Efficacy, safety, and cost-effectiveness of glatiramer acetate in the treatment of relapsing–remitting multiple sclerosis

“…A more recent Cochran meta-analysis, however, concluded that GA had no effect on MS disease progression [Munari et al 2004]. Their conclusion was consistent with results from a prospective, randomized, placebo-controlled trial of 943 primary progressive MS (PPMS) patients (PROMiSe Trial) that failed to show a treatment effect of GA to slow disease progression (HR 0.87; 95% CI ¼ 0.711.07; p ¼ 0.175).…”

Experimental allergic encephalomyelitis: A misleading model of multiple sclerosis

“…The spectrum of agents and approaches that showed promising results in EAE is immense and range from turmeric (used in Asian cooking) and Padma-28 (exotic natural drug found in health food stores) to modern genetic manipulation of the immune system with cytokines and antigen. 63 Glatiramer acetate is modestly effective in reducing relapses but has not prevented the progression of MS. 64 The reasons for this failure are not only, as shown here, that MS and EAE differ quite substantially, but also that even from the larger, more comprehensive picture, most of the evidence suggests that the EAE models do not reflect the pathology of a progressive disorder as MS. 61,62 Glatiramer acetate represents the only drug currently in use whose application in a clinical setting was first proved useful in EAE.…”

“…61,62 Glatiramer acetate represents the only drug currently in use whose application in a clinical setting was first proved useful in EAE. 63 Glatiramer acetate is modestly effective in reducing relapses but has not prevented the progression of MS. 64 The reasons for this failure are not only, as shown here, that MS and EAE differ quite substantially, but also that even from the larger, more comprehensive picture, most of the evidence suggests that the EAE models do not reflect the pathology of a progressive disorder as MS. Moreover, the various EAE models are dissimilar in their pathology and immunology to such an extent that it is unclear why one EAE model will be better served than another.…”

The efficacy of glatiramer acetate in beta-interferon-intolerant MS patients

“…None of the patients stopped GA therapy due to the lack of efficacy but rather because of side effects, which emphasizes the need for development of new therapeutic options for the treatment of MS. The most commonly reported adverse effects, injection‐site reactions and chest tightness, were similar to those observed in earlier trials with GA (3, 8, 10). Considering the selected patient population in this study, the discontinuation rate of 27% was lower than anticipated, but approximately at the same level as observed in a 6‐year GA trial (8).…”

Efficacy, safety, and cost-effectiveness of glatiramer acetate in the treatment of relapsing–remitting multiple sclerosis

“…A more recent Cochran meta-analysis, however, concluded that GA had no effect on MS disease progression [Munari et al 2004]. Their conclusion was consistent with results from a prospective, randomized, placebo-controlled trial of 943 primary progressive MS (PPMS) patients (PROMiSe Trial) that failed to show a treatment effect of GA to slow disease progression (HR 0.87; 95% CI ¼ 0.711.07; p ¼ 0.175).…”

Experimental allergic encephalomyelitis: A misleading model of multiple sclerosis

“…The spectrum of agents and approaches that showed promising results in EAE is immense and range from turmeric (used in Asian cooking) and Padma-28 (exotic natural drug found in health food stores) to modern genetic manipulation of the immune system with cytokines and antigen. 63 Glatiramer acetate is modestly effective in reducing relapses but has not prevented the progression of MS. 64 The reasons for this failure are not only, as shown here, that MS and EAE differ quite substantially, but also that even from the larger, more comprehensive picture, most of the evidence suggests that the EAE models do not reflect the pathology of a progressive disorder as MS. 61,62 Glatiramer acetate represents the only drug currently in use whose application in a clinical setting was first proved useful in EAE.…”

“…61,62 Glatiramer acetate represents the only drug currently in use whose application in a clinical setting was first proved useful in EAE. 63 Glatiramer acetate is modestly effective in reducing relapses but has not prevented the progression of MS. 64 The reasons for this failure are not only, as shown here, that MS and EAE differ quite substantially, but also that even from the larger, more comprehensive picture, most of the evidence suggests that the EAE models do not reflect the pathology of a progressive disorder as MS. Moreover, the various EAE models are dissimilar in their pathology and immunology to such an extent that it is unclear why one EAE model will be better served than another.…”