Licensed to reduce the relapse frequency in multiple sclerosis. Only to be used in relapsing-remitting multiple sclerosis in patients who are ambulatory and have had two clinical relapses in the last two years.
The initial mechanism of an acute multiple sclerosis demyelinating event is thought to be inflammatory - and therefore suppressing this process with immuomodulating drugs may be beneficial.
Those with progressive disease and no recognisable relapses are not prescribed immunomodulating drugs. Studies have found that there is no evidence that it halts the disease in those with progressive symptoms. The mechanism of progressive MS may not be a wholly inflammatory one and more neurodegenerative, due to a gradual loss of axons, and this may be why these drugs are less effective.
Glatiramer acetate is an immunomodulating drug made of synthetic polypeptides. It's mechanism of action is not wholly clear but may be due to:
- Induction of antigen specific suppressor T cells
- Binding to MHC molecules and so displacing bound MBP
- Altering the balance between proinflammatory and regulatory cytokines
It has been found to reduce the number of clinical (and subclinical events - new demyelinating lesions seen on MRI but with no new symptoms).
Subcutaneous.
No interactions with glatiramer have been reported.
Patients should understand that this is a medication which is to reduce relapse rate rather than produce a reduction in disability in those with progressive multiple sclerosis. Also, patients should be aware that they may be taken off the medication if it is found to be ineffective and they no longer fit the criteria.
Nil relevant.
