Treatment
Copaxone (Glatiramer Acetate) ( refT7 )
The active ingredient of Copaxone , glatiramer acetate, is a synthetic compound of four amino acids. Copaxone may be given to reduce relapses in people with relapsing-remitting MS. Such people should be ambulatory (able to walk) and have had at least two relapses in the last 2 years.
Copaxone is given as a daily subcutaneous injection (under the skin). The dose is 20 mg (milligrams). Decisions about the length of treatment should be made by the treating physician on an individual basis.
Copaxone should not be given to (ie is contraindicated in) women who are pregnant or who are planning to become pregnant. It should not be used in children and people known to be allergic to glatiramer acetate or mannitol. It has not been studied in the elderly. Caution should be exercised in people with heart disease.
The most common side-effects are redness, pain, swelling, itching or a lump at the site of injection. These reactions are usually mild and seldom require professional treatent.
Some people report a short-term reaction immediately after injecting Copaxone. This reaction can involve flushing (feeling of warmth and/or redness), chest tightness or pain with heart palpitations, or trouble with breathing. These symptoms generally appear within minutes of an injection, are short lived and go away by themselves without further problems.
Less-common side-effects include diarrhoea, flu-like symptoms, back pain, headache, nausea, depression, dizziness, rash, joint pain, anxiety and diarrhoea or constipation. Rarely, seizures and anaphylactic shock have been reported.
If reactions to Copaxone are severe, or if convulsions or anaphylactic shock occur, treatment should be stopped and the condition managed appropriately.
Licensed in 2002, Copaxone is manufactured by Teva Pharmaceuticals Ltd.
More detailed prescribing information on Copaxone can be found by going to www.medicines.org.uk. Typing Copaxone into the search box and pressing Go will bring you to the patient information leaflet usually packaged with the drug.
The Association of British Neurologists provides guidelines on the use of glatiramer acetate (refT4). Among its recommendations are the suitability of people with MS for the treatment and the criteria that should be used to stop therapy.
Suitability of Patients:
Glatiramer acetate is an appropriate treatment for patients with RR-MS provided they fulfil the
following criteria:
1. Are able to walk at least 100 metres independently.
2. Have had at least two clinically significant relapses in the last 2 years.
3. Are aged >18 years.
Stopping Criteria:
Treatment should be stopped in patients taking glatiramer acetate if there are intolerable side
effects or if a pregnancy is planned. The treatment should also be stopped if it does not appear to
be effective - for example, if:
1. The person experiences two disabling relapses within 12 months, as certified by a
neurologist.
2.
Secondary progressive MS
and disability develops.
3. There is a loss of ability to walk, with or without assistance, for at least 6
months.