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)

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