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ABC Treatments Multiple Sclerosis

the first ABC Treatments Multiple Sclerosis

ABC Treatments Multiple Sclerosis:

I remember when we first heard about the ABC treatments for multiple sclerosis. This is the name given to three of the earliest FDA approved immunomodulating drugs for treating multiple sclerosis. It was exciting (at least I thought so).

Someone was always asking Cir,

"Which one of the abc drugs are you using?"

Cir would answer, telling them which treatment he was using at the time. It was the MS "in" thing to do. And Cir's doctors encouraged him to at least consider taking one of them. According to the studies, each one of the abc treatments is shown to decrease the number of relapses or lessen the effects of MS symptoms.

Know Your ABC's

The "A" of the ABC treatments for multiple sclerosis is avonex or interferon beta-1a. I always thought the beta part was interesting. Avonex is a once-a-week injection medication given intramuscularly (injected into the muscle). It is used to treat the relapsing forms of multiple sclerosis.

The "B" of the ABC treatments is betaseron. Betaseron or interferon beta-1b - there goes that beta thing again - is also an injection that is taken 3 times a week. It is given subcutaneously (injected just below the skin). It treats the relapsing forms of MS also. This includes secondary-progressive MS where there are sometimes relapses.

Last but not least is "C". Copaxone or glatiramer acetate, is the third of the ABC treatments for multiple sclerosis. It is an injection taken once daily. Like Betaseron, it is given subcutaneously.

An ABC Treatments Multiple Sclerosis Update:

As mentioned above, the term "ABC" of multiple sclerosis (MS) treatments historically refers to a group of disease-modifying therapies that were among the first approved for managing relapsing forms of MS.

These 3 treatments used to be the only ones available. Now there are so many more treatments that may be more effective. You can decide which one out of all of them is the best one for your particular situation.

1. Avonex (Interferon beta-1a):

• Mechanism of Action: Avonex is an injectable form of interferon beta-1a, delivered intramuscularly once a week. It helps manage the immune response by reducing the activity of the immune system, thereby decreasing the inflammatory processes that lead to nerve damage in MS.
• Effectiveness: Studies have shown that Avonex can reduce the frequency of relapses and help slow the progression of physical disability. It primarily targets the relapsing-remitting form of MS.
• Side Effects: Common side effects include flu-like symptoms, which tend to be more pronounced during the initial weeks of therapy but often decrease over time. Regular liver function tests and blood counts are recommended due to potential effects on liver and blood cells.
• Relevance Today: While Avonex remains a treatment option, newer therapies with different mechanisms and administration methods have become popular. Its once-weekly dosing is still considered convenient compared to some of the other injectable therapies.

2. Betaseron (Interferon beta-1b):

• Mechanism of Action: Betaseron is similar to other beta interferons but is administered subcutaneously every other day. It functions by modulating the immune response to decrease MS relapses and slow disability progression.
• Effectiveness: It has been effective in reducing the relapse rate and delaying the accumulation of physical disability in people with MS. Betaseron is also indicated for use in secondary-progressive MS with relapses.
• Side Effects: Similar to other interferons, you may experience flu-like symptoms, injection site reactions, and potential liver function changes, requiring regular monitoring.
• Relevance Today: Betaseron remains a viable option for some MSers but it faces competition from oral and infusion therapies, which might offer fewer side effects and more convenient dosing schedules.

3. Copaxone (Glatiramer acetate):

• Mechanism of Action: Copaxone is a non-interferon, non-steroidal treatment. It's thought to work by altering the immune system's attack on myelin by acting as a decoy. It is administered via subcutaneous injection daily or three times a week.
• Effectiveness: Copaxone has shown effectiveness in reducing the frequency of MS relapses and is considered a generally well-tolerated treatment over the long term.
• Side Effects: The most common side effect is injection site reactions, such as redness or swelling. Unlike the interferon medications, flu-like symptoms are less common.
• Relevance Today: Copaxone has maintained its role in MS treatment due to its distinct mechanism and established long-term safety profile. However, with the introduction of generic versions and other oral and infusion therapies, it may be a less common choice among healthcare providers.

To Copaxone or Not to Copaxone

Cir has tried each one of the ABC drugs. He stayed with copaxone the longest. He would try one of the interferons but would end up back on the copaxone. It had the least side-effects. Even though copaxone has to be taken everyday, he could handle that better than having to deal with the side-effects of the interferons.

We know several people who can take the interferons with no problem. They enjoy the freedom of the once-a-week avonex injection or the three times per week betaseron injections. Their bodies are able to tolerate the interferons. The side-effects either go away in time or they can put up with them better than Cir could.

(They have a higher tolerance for pain - maybe?)

Current Landscape of MS Treatments

Over the past several years, MS treatment has evolved significantly. There are newer oral medications such as fingolimod (Gilenya), dimethyl fumarate (Tecfidera), and infusion therapies like ocrelizumab (Ocrevus) and Tysabri which offer different administration routes. They may be more appealing to you if you are seeking an alternative to the injectable therapies.

These newer treatments may also provide advantages in terms of efficacy and the side effects may be less of a problem for you. So, while the ABC drugs played a pivotal role in MS management in the beginning, the growing array of new options enable healthcare providers to offer more personalized treatment strategies.

It's very important that you work closely with your healthcare provider to choose the most suitable therapy based on disease activity, your lifestyle preferences, and potential side effects. (Link above opens a new window to My MS Team)

To read about Cir's experience with Avonex click here.

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