This Is MS Multiple Sclerosis Community: Knowledge & Support

As if some $4 billion revenue a year from the CRAB drugs isn't enough. A trial of Avonex and Copaxone. Not sure if you get two for the price of one. Unfortunately these sorts of trials will drawn in sufferers who could have tested some more promising drugs!

Copaxone was in trial with minocycline but this has gone quiet. I suspect that the small trial of monocycline alone put the wind up the CRAB manufacturers.

You can imagine a trial in the future of a huge syringe containing all four CRAB drugs. They can smell that their day is almost over but won't go down without a fight.


http://www.nationalmssociety.org/Research-2006Jan27.asp

Nice to see the NMSS is still plugging away! And CRAB annual revenues are more like $4-5 BILLION

The only really useful part of this study, as I see it, is to look into different biomarkers for responsiveness among the patients. That was one of the big questions I had when presented with the CRAB choices - which (if any) would most effectively work for me? Is there any way to tell? Should I just pick one and hope I made the best choice? DO I FEEL LUCKY?? That's what it comes down to. In the absence of any better treatments, such information about existing treatments is critical, but I don't believe it exists, at least not in a form available to clinicians actually prescribing the drug.

I had read there was a researcher at Baylor in TX that was developing a screen for newly diagnosed MS patients that would indicate their degree of individual responsiveness to CRABs so they could make the best pick. I don't know if anything has come of that research.

Since I know I can't tolerate Copaxone and probably can't tolerate a RAB, either, I wonder how many people will make the cut of being able to tolerate BOTH for three years (and then presumably beyond). Seven days a week of Copaxone and weekly IM Avonex. Ouch. Even if they work together a little better than each one alone, would it be worth it?? The gain of the two together would have to be pretty significant. Injections aside - the costs of both medications would be very expensive, running up to $20K+ a year. Their secondary objective is safety and tolerability. I don't know about safety, but I suspect the tolerability is going to be a bottleneck before they get to their primary endpoint of counting relapse reduction, unless they get an especially stoic group of subjects. They mention a small pilot study that indicated safety. I wonder how long the pilot study ran. Anyone know?

Lisa

Brownsfan,

Sorry a typo by me - should have read billion.

Lisa, the responsiveness to the CRABs is a real lottery. One of the neuros I saw advised me to start one of the CRABS - I said I was less than impressed with the 30% efficacy reported. He said to me that some people do much better. When I responded that some people would therefore see no benefit / hardly any benefit - he just shrugged his shoulders.

Ian

Ian,

Yes, some people seem to do better with one or the other, and conversely (like you pointed out) that means some people would get no benefit from the drug they happened to pick. I'm a bit surprised, given the number of clinical trials that have been done with these drug and the spotty response rate, that there still isn't a better way to identify (in advance of a drug selection) what individual characteristics might improve the response rate to one one drug versus another and save patients not only the pain and expense of an ineffective drug, but also the lost time to slow progression on the one more effective.. It was my impression this was what was being researched at Baylor University, but I have read nothing more about that since summer of 2004.

This current trial will not be completed until about 3 years from now, so publication may not show up for four years or more. I would HOPE something else will be out by then.

I am very interested in any outcome of a clinical arm where an antibiotic is tested alone head-to-head against Copaxone. So there is no news?

Lisa