Copaxone is a very popular treatment for Relapsing Remitting MS. Being the only approved medication for RRMS that is not an interferon, it offers a less severe side effect profile. Unfortunately, it is also the only treatment that requires an injection every single day... or does it?

A recent study showedthat many Copaxone users, particularly women, experience lipoatrophy ("dents" around the injection sites). This has created a great deal of interest in the idea that maybe it is not necessary to do daily injections. Spawning this idea was the rumor that studies had been done on Copaxone showing that every other day injections are just as effective as every day. It is not a rumor...

In an effort to educate our community as much as possible, we have located and now published these two studies. Be forewarned, they are very small and the results are not necessarily statistically significant. That being said, they show that skipping a day is about as effective as every day dosing, and the side effects were reduced. Excerpts follow:

"The authors reported that results with alternate day therapy were not statistically different from those achieved with daily treatment, aside from a lower dropout rate with alternate day methods."

"The most common adverse events reported with glatiramer acetate were injection site reactions, which appeared to be more frequent with [every day] vs [every other day] dosing."

To read the full article, click here or just go to our download section under Copaxone.

To Teva's (the manufacturer of Copaxone) credit, if you call their patient services arm Shared Solutions and ask them for this information, they will send it to you. But they will remind you, rightfully so, that Copaxone has only been approved (and thus, can only be recommended) for every day dosing.

This is a serious point, and let's please be clear: we are not posting this so that you will feel confident in switching yourself away from daily injections-- if you choose to pursue that route, that is a decision that MUST be made with your doctor's consent and not by yourself. These are small studies and while promising, they do not rigorously prove that every other day is as effective as every day, and the very real possibility exists that one could do great harm to themselves by reducing their dosage. While This is MS is open to experimentation, taking risks on your mainline treatment without the participation of your doctor is NOT advised. Instead we recommend that you print this study out and take it with you on your next neuro visit.

Teva just launched pre-mixed, pre-filled Copaxone in Europe... we suppose it is much more convenient than having to mix it oneself. However, the fact remains that it is still a daily injection-- and we suspect that attribute is where the main inconvenience comes from.

"Aventis and Teva Pharmaceutical Industries Ltd. today announced that the Multiple Sclerosis (MS) treatment COPAXONE® (glatiramer acetate injection) is now available also in Europe in a pre-filled, ready-to-use syringe (PFS). For physicians, nurses and pharmacists, compliance and adherence to treatment are among the most important factors in any therapy. With COPAXONE® PFS injection will be faster and more convenient. No mixing or preparation is required, and, fewer supplies are needed, ensuring increased accuracy, better compliance, and reduced risk of contamination...

'The new pre-filled syringe is about meeting patients' needs for a treatment that is convenient, consistent and complete,” said Israel Makov, President and CEO of Teva. "The COPAXONE® PFS offers important and improved benefits for patients who already use our product, and will increase COPAXONE®'s appeal to additional MS patients throughout Europe. This is another step towards making COPAXONE® the drug of choice for MS patients in the European market...'"

Click "read more" for the full story...

This study makes the suggestion that Copaxone could very well be useful as a treatment for Primary Progressive Multiple Sclerosis, particularly in men. However, there was a (strangely enough) low rate of progression in both the placebo and the drug groups, and so statistical significance was not reached. Still, this bodes well for PPMS'ers who until now really have had no sanctioned CRAB treatment choice (Novantrone is approved for PPMS, and anecdotally Low Dose Naltrexone has shown efficacy in this subgroup as well).

"Treatment with COPAXONE® (glatiramer acetate injection) may provide beneficial effects in patients with primary progressive multiple sclerosis (PPMS), according to new data presented late yesterday at the 56th Annual Meeting of the American Academy of Neurology. In a post-hoc analysis of all available data from the intention-to-treat cohort, men treated with COPAXONE® were found to have significantly slower rates of progression of the disease than those treated with placebo. No overall benefit was shown, a result that may have been driven by the low rate of progression in the study population. "

Click "read more" for the full article...

This new study shows remarkable efficacy for Copaxone in a 10 year trial. Even so, take it with a grain of salt, as these long-term studies can easily be skewed (e.g., if someone was not doing well even on therapy and quit the drug, they look the same as someone who quit the drug and then began doing worse).

"Relapsing-remitting multiple sclerosis (RRMS) patients who remained on COPAXONE® (glatiramer acetate injection) therapy for an average of 10 years experienced significantly less progression of disability than patients who withdrew from the open-label, long-term follow-up study...

According to data presented late yesterday at the 56th annual meeting of the American Academy of Neurology, more than 90 percent of the 108 patients still on COPAXONE® did not show evidence of disease progression to an EDSS of 6.0 on the Expanded Disability Status Scale (EDSS). In comparison, 50 percent of the 47 patients who withdrew from COPAXONE® therapy after an average of 4.5 years progressed to this score."

Click "read more" for the full article-- if you're considering getting on Copaxone, this is a very important read.

This study critically evaluates all the previous studies on Copaxone. The conclusion is that Copaxone is indeed an effective therapy for Multiple Sclerosis-- an important deduction considering that there is always some controversy bouncing around regarding Copaxone's efficacy, given that it is very different in its approach than the other proven treatments.

"Glatiramer acetate (Copaxone^®, Teva Pharmaceuticals Ltd) is a collection of immunomodulatory, synthetic polypeptides indicated for the treatment of relapsing-remitting multiple sclerosis (RR MS)...

The efficacy of glatiramer acetate is stable or may increase over time and the drug has a favourable side effect profile. Glatiramer acetate is an appropriate first-line immunomodulatory therapy for RR MS."

Click "read more" for the full abstract...