Other MS Treatment Options
Learn all you can
Because multiple sclerosis (MS) is a lifelong condition that typically gets worse over time, it's important to start treatment as soon as possible after your diagnosis. Just as important, working with your doctor to choose your MS treatment is a healthcare decision that will affect the rest of your life. Learning all you can now is the best way to feel confident in that decision tomorrow. So be sure to evaluate each option for effectiveness, safety, experience, and convenience.
As you read about each medication below, keep in mind that MS is thought to be an autoimmune disease that begins when your immune system mistakenly attacks your central nervous system (CNS).
Select an MS treatment option to consider
Considering Copaxone?
Remember: A key goal of MS therapy is to delay the progression of physical disability. While AVONEX is FDA approved to slow physical disability progression in MS, Copaxone is not.
MS attacks in multiple ways—your treatment should, too
To understand how Copaxone is thought to work, it helps to remember how MS affects your brain. Normally, the blood vessels in your brain are protected from bacteria and harmful substances in your blood by a wall of cells known as the blood-brain barrier. When you have MS, holes appear in your blood-brain barrier. This allows immune cells to cross into your CNS where they can cause damaging inflammation or lesions.
Copaxone is not believed to have an effect on the blood brain barrier. However it is thought to modify immune cells entering your CNS so that they work to fight MS inflammation.
Daily injections really add up
Unlike once-weekly AVONEX, Copaxone must be injected every day. In two separate studies, conducted by surveying almost 3,500 people with MSa, people taking daily Copaxone were the most likely to have missed at least one dose of their MS treatment in the previous four weeks. People taking once-a-week AVONEX were the least likely to miss doses.
- Study one: 51% of people taking Copaxone missed doses, compared with 21% of people taking AVONEX
- Study two: 34% of people taking Copaxone missed doses, compared with 15% of people taking AVONEX
You can't benefit from a therapy you forget or neglect to take. So as you consider your treatment options, it's important to be realistic about the way each medication would fit into your schedule and lifestyle.
a. The first study surveyed 798 people with MS. The second surveyed 2,648.
Considering Rebif?
Because MS can progress even if you "feel fine," the earlier you start treatment, the better. While AVONEX is FDA approved to work from the first attacka, Rebif is not FDA approved to work unless you've had at least two flare-ups.
Injection site reactions and flu-like symptoms
Because Rebif is both a high-dose, high-frequency interferon and subcutaneous, it has high rates of
both ISRs and FLS as shown in a one-year clinical trial.
Learn more about side effects.
Higher dose doesn't always mean stronger treatment
You may have heard that Rebif is more effective than AVONEX. This is based on the first six months of a one-year study, comparing the number of people who did not experience flare-ups. But MS is more than just flare-ups and it lasts more than six months.
To see the bigger picture, consider the results from two separate studies comparing AVONEX and Rebif.
Fight the disease, not the treatment
Rebif, like AVONEX, is a form of interferon beta. Interferons are proteins made by your own body to fight infections. Sometimes, however, if you take medications containing an interferon, your immune system may mistake this form of interferon for a foreign substance, like a bacteria or a virus, and create antibodies to attack it. Once created, these antibodies may become a permanent part of your immune system. Although the significance of these antibodies is not fully understood, they may cause you to become resistant to your medication, making it less effective.
In an 18-month study, 19% of people taking Rebif developed antibodies against interferon beta, as compared with 4% of people taking AVONEX.
In a lifelong condition like MS, you don't want to become resistant to your treatment.
a. AVONEX is effective for people with relapsing MS, including people who have experienced a first flare-up and have lesions consistent with MS on their MRIs.
Considering Betaseron or Extavia?
While AVONEX is FDA approved to slow physical disability progression, helping you stay active longer, Betaseron and Extavia are not. What's more, AVONEX is taken once a week. Betaseron and Extavia are taken every other day.
Injection site reactions and flu-like symptoms
Like Rebif, Betaseron is both a high-dose, high-frequency interferon and subcutaneous (SC), and it has shown high rates of both ISRs and FLS in a two-year clinical trial.
Fight the disease, not the treatment
Betaseron, like AVONEX, is a form of interferon beta. Interferons are proteins made by your own body to fight infections. Sometimes, however, if you take medications containing an interferon, your immune system may mistake this form of interferon for a foreign substance, like a bacteria or a virus, and create antibodies to attack it. Once created, these antibodies may become a permanent part of your immune system. Although the significance of these antibodies is not fully understood, they may cause you to become resistant to your medication, making it less effective.
In an 18-month study, 32% of people taking Betaseron developed antibodies against interferon beta, as compared with 4% of people taking AVONEX.
In a lifelong condition like MS, you don't want to become resistant to your treatment.
a. Betaseron and Extavia are two brand names for the same medication. There have not been any clinical studies of Extavia.
Considering Gilenya?
Because MS can progress even if you "feel fine," the earlier you start treatment, the better. While AVONEX is FDA approved to work from the first attacka, Gilenya is not FDA approved to work unless you've had at least two flare-ups.
How Gilenya is thought to work
As with all relapsing MS treatments, the way Gilenya works to fight the disease is not fully understood. To understand how Gilenya is thought to work, it helps to know more about how MS affects your brain. Normally, the blood vessels in your brain are protected from substances in your blood by a wall of cells known as the blood-brain barrier. When you have MS, holes appear in your blood-brain barrier. This allows immune cells to cross into your CNS where they can cause damaging inflammation or lesions.
Doctors believe Gilenya takes most of a certain type of invading immune cell out of circulation, which prevents them from damaging your CNS. However, these cells are also needed to fight infections throughout your body.
Experience matters
With a lifelong condition like MS, you need to think about the impact your treatment may have over time. AVONEX has more than 20 years of treatment experience and has been prescribed to more people than any other MS treatment. In addition, the safety profile of AVONEX is well understood. Gilenya was first approved in late 2010 so its long-term safety profile is still unknown.
a. AVONEX is effective for people with relapsing MS, including people who have experienced a first flare-up and have lesions consistent with MS on their MRIs.
Take time to consider your options.
In addition to discussing your treatment options with your doctor, you may find it helpful to talk things out with your family and friends. Use the chart below as a starting point for these conversations. It will help you remember some of the details about these treatment options:
* AVONEX is effective for people with relapsing MS, including people who have experienced a first flare-up and have lesions consistent with MS on their MRIs.
Make notes to yourself on your own thoughts and your conversations with others. Discuss any remaining questions you have with your doctor. The time you invest now may have a lifelong impact on your ability to manage your MS over time.
Safety and efficacy of treatment with AVONEX beyond three years is not known.
Talk with your doctor to find out if AVONEX is right for you.
You are encouraged to report negative side effects to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
For additional important safety information, please see the full Prescribing Information and Medication Guide. This information is not intended to replace discussions with your doctor.
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