Medication for MS

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Click name of drug to see a video:

 Copaxone (Glatiramer Acetate) *Comes in Generic, Injections 3 times a week, 29% effective at preventing attacks. 

-Copaxone Side Effects: Some patients report a short-term reaction right after or within minutes after injection.

-How Copaxone works: interacts with those elements within the immune process that are believed to be responsible for multiple sclerosis. It is thought to work for people with MS by regulating their immune system so as to reduce and possibly counteract the immune damage occurring in MS.

AUBAGIO (teriflunomide) 1 pill a day 31% effective. 

-Aubagio Side Effects: Reduced white blood cell count, numbness or tingling in hands or feet, allergic reactions, including serious skin problems, breathing problems (new or worsening), high blood pressure, patients with low white blood cell count should not receive certain vaccinations during treatment and 6 months after. 

- How it AUBAGIO works: blocks an enzyme called DHODH that these overactive cells need to keep multiplying at their overactive rate. 

Avonex, Beta Seron, Extavia, Plegridy, Ribiff (Interferon), Injections, 33%, 34%, 34%, 36%, 33% effective respectively. 

-Interferon Side Effects: The most common side effect is Flu-like symptoms. Others include injection site reactions, trouble with your mood. Serious side effects are rare but include Behavioral health problems, suicidal thoughts, serious liver problems, digestion problems, bleeding, respiratory trouble, and skin reactions. 

-How Interferons work: are natural substances produced by the body to help it fight against attacks such as infections caused by viruses. The exact way that they work in MS is not yet known but interferons seem to calm the immune system down, and prevents relapses of MS. 

Mayzent (Siponimod) Oral medication 55% effective in preventing disease activity and prevents disability progression in SPMS by 29%.

- Mayzent Side Effects: headache, hypertension, swelling, nausea, dizziness, diarrhea.

-How it works: By binding to the 

Mavenclad (Cladrabine) 58% effective Mavenclad is taken by mouth in two treatment courses, twelve months apart.

-Side Effects: Potential safety issues identified by the FDA include decrease in white blood cells, and increased risk of infections and liver injury. The most common adverse reactions reported during clinical trials included upper respiratory tract infections, headache, and low white blood counts.

-How it works: Mavenclad is a compound that targets certain types of white blood cells (lymphocytes) that drive the immune attack in MS. It temporarily reduces the number of both T and B lymphocytes without continuous suppression of the immune system.

Gilenya (fingolimod), 1 pill a day, 54% effective. 

-Gilenyia Side Effects: Headache, tired feeling, influenza, stuffy nose, sinus pain, diarrhea, back pain, liver transaminase elevations, and cough. Rare serous effects include PML, macular edema, posterior reversible encephalopathy syndrome, respiratory effects, liver injury, fetal Risk, increased blood pressure, cutaneous malignancies, and Immune system effects following GILENYA discontinuation. 

-How Gilenya works: It binds to the surface of white blood cells (lymphocytes) in the blood, and these cells are then trapped in the lymph glands, which prevents the lymphocytes from crossing into the central nervous system and causing inflammation and damage.

Lemtrada (alemtuzumab), Series of infusions, 55% effective.

-Lemtrada Side Effects: Rash, headache, fever, runny nose, sore throat, nasal congestion, nausea, urinary tract infection, fatigue, insomnia, upper respiratory tract infection, herpes viral infection, hives, itching, thyroid gland disorders, fungal infection, joint pain, pain in extremity, back pain, diarrhea, sinus infection, mouth and throat pain, numbness or tingling, dizziness, abdominal pain, flushing of the face/neck/chest, vomiting, cough, chills, changes in sense of taste, flu symptoms, skin swelling, indigestion, blood in the urine, shortness of breath, fast heartbeat, anxiety, weakness, or muscle pain. Serious side effects include serious autoimmune problems, Immune thrombocytopenia, kidney problems, serious infusion reactions, may increase your chance of getting some kinds of cancers, low blood counts, serious infections, lung and gallbladder.

-How Lemtrada works: It works by binding to and killing immune cells (lymphocytes or white blood cells) which are involved when the immune system attacks myelin. It is thought that the immune cells which grow back after treatment do not cause damage to nerves. 

 
Navantrone (Mitoxantrone),Infusions (max 4), 66% effective.

-Navantrone Side Effects: Nausea, vomiting, diarrhea, headache, or unusual tiredness may occur. 

-How Navantrone works: It works by suppressing the immune system to lessen its attack on the myelin sheath that surrounds nerves. It can slow increases in disability and reduce the relapse rate in people with worsening forms of relapsing-remitting, progressive-relapsing, and secondary-progressive MS. 

Tysabri (Natalizumab), Monthly Infusion, 68% effective.

-Tysabri Side Effects: The most common symptom reported is a sensation of feeling better. Negative side effects include headache, tired feeling, joint or muscle pain, redness or irritation at the injection site. Serious side effects: Herpes infections, liver damage, allergic reactions, weakened immune system, PML (1 in 1000). 

- How Tysabri works: It keeps the white blood cells of the immune system from entering the brain and spinal cord, which doctors think plays an important role in the damaging effects of MS. 

Ocrevus (ocrelizamab), Periodic Infusions, 70% effective.

-Ocrevus Side Effects: Infusion reactions infections, slight increase in malignancies (breast cancer & tumors), upper respiratory infections, PML...

-How Ocrevus works: Ocrevus is a humanized monoclonal antibody that is designed to target CD20-positive B cells. Although the exact way OCREVUS works is not known, it is thought to work in MS by decreasing certain B cells which have the CD20 protein on its surface. 

*Rituxan (rituximab), Not FDA approved for MS- prescribed off label (often not covered by insurance), Periodic Infusions, 70% effective. -Rituxan Side Effects: Injection reactions, fever, chills, body aches; feeling tired; joint pain; or cold symptoms.

-How it Rituxan works:Rituxan targets the immune system to help calm the inflammation that scars nerves, leading to disease progression. The drug works by targeting cells in the immune system called B cells, which make antibodies that contribute to the disease process.

** How Ocrevus & Rituxan compare/differ:Ocrevus and Rituxan both target CD20-positive B cells, they are different molecules in their structure and how they interact with the immune system. Rituxan is a chimeric antibody, composed of both mouse and human parts. The immune system may form antibodies against the Rituxan making the effectiveness of the medicine over time. This has not been true with Ocrevus which is a humanized molecule.