glatiramer acetate (Copaxone)

Glatiramer acetate (also known as Copaxone) is a medication made by TEVA pharmaceuticals.   It works by competing with chemicals similar to myelin basic protein for activation of T cells.   One of the effects of this is downregulation of inflammatory responses in the brain.

Administration:  It is injected under the surface of the skin (subcutaneous)

Forms:
generic and brand name forms 20 mg daily, subcutaneous
brand name form only 40 mg, three times per week, subcutaneous

The cost of glatiramer acetate varies for the generic (about $18000/year) and brand name ($66000/yr) forms.

Possible side effects:

Redness, pain swelling or itching may occur at the injection site.  A person may feel flushing, anxiety, trouble breathing, lasting less than 15 minutes.  Indentations under the skin sometimes occur.

Literature review

Khan O et al.  2013.  Three times weekly glatiramer acetate in relapsing remitting multiple sclerosis.   Ann Neurol 2013 Jun; 73(6): 705-13
Results: Over 12 months, 1400 pt with MS enrolled; 34% reduction in relapse rate with 3x/wk glatiramer acetate compared to placebo

Johnson, K.P. et al. 1995   Copolymer 1 reduces relapse rate and improves disability in relapsing-remitting multple sclerosis: results of a phase III mutlicenter, double-blind placebo-controlled trial.  The Copolymer 1 Multiple Sclerosis Study Group.  Neurology.  Jul; 45(7) 1268-76
Results: 251 patients enrolled, over 24 months, copolymer 1 resulted in 29% reduction of relapses of MS, compared to placebo