“The following study shows that MSers who are not responding to IFNbeta and are switched to GA have the potential to do relatively well. This open-label study comes quite late in the life-cycle of GA and is unlikely to change clinical practice. Recent data presented at the American Academy of Neurology from MSBase showed that MSers switching from IFNbeta to fingolimod did better on average than patients switching from IFNbeta to GA. If we all adopt treat-2-target of NEDA to try and prevent end-organ damage I suspect very few neurologists and MSers would choose GA, an injectable, over fingolimod, a tablet. What would you do? Some argue that the safety profile of GA is so good who would take a chance of using a newer agent with an unproven long-term safety record? I would also remind you that there are no tests we can do to determine who will be a GA-responder of non-responder. The only way to assess the latter is by putting you on the treatment and monitoring you over a 6-24 month period. The danger of the latter approach is that damage acquired during the observation period of say 24 months is probably irreversible; we know this from the extension studies of numerous phase 3 trials. This post highlights the complexities of MS DMTs and the decision-making that underpins them. It is really a brave new world.”
Epub: Ziemssen et al. A 2-year observational study of patients with relapsing-remitting multiple sclerosis converting to glatiramer acetate from other disease-modifying therapies: the COPTIMIZE trial. J Neurol. 2014 Aug 14.
Background: Studies suggest that patients with relapsing-remitting multiple sclerosis (RRMS) who do not benefit from other disease-modifying treatments (DMTs) may benefit from converting to glatiramer acetate (GA).