Copaxone® (glatiramer acetate)

Parent company: Teva Neuroscience, Inc.

Given through daily subcutaneous injections; dosage is 20 mg.

Approved for RRMS.

It has been shown to significantly reduce the annual relapse rate in relapsing-remitting individuals.

Copaxone is a synthetic protein that mimics myelin basic protein, a key component of the myelin sheath that is damaged in MS; it appears to block immune system T cells that damage myelin by acting essentially as a decoy. Copaxone also increases anti-inflammatory lymphocytes and brain-derived neurotrophic factor (BDNF), with potential neuroprotective effects.

A pilot study with daily double-dose Copaxone versus single-dose Copaxone suggested it reduced relapses and lesions as seen on MRI. However, the company recently announced that a second study did not confirm a difference.

The 36-month PreCISe study has shown a successful delay in the conversion of clinically isolated syndrome (CIS) to clinically definite MS (CDMS).

RRMS patients receiving long-term Copaxone treatment showed more life satisfaction, better health, and greater satisfaction with therapy than untreated individuals or those receiving only short-term treatment with Copaxone or interferon beta.

Combination and Comparative studies:
The COMBI Rx trial will compare the combination of Avonex plus Copaxone to Copaxone alone and Avonex alone.

Another study looks at Copaxone combined with oral minocycline; the combination reduced the number of new and active lesions; also reported to be safe and well tolerated.

A currently recruiting trial is studying the effect of combining Copaxone and estriol in RRMS on relapse rate. A pilot study using the same combination had encouraging results.

An ongoing study of prednisone in 500 relapsing MS patients treated with Copaxone will measure changes in brain volume after three years as its primary outcome.